Maternal Diabetes and the Risk of Autism Spectrum Disorders in the Offspring: A Systematic Review and Meta-Analysis
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We performed a systematic literature search regarding maternal diabetes before and during pregnancy and the risk of autism spectrum disorders (ASD) in the offspring. Of the 178 potentially relevant articles, 12 articles including three cohort studies and nine case–control studies were included in the meta-analysis. Both the meta-analyses of cohort studies and case–control studies showed significant associations. The pooled relative risk and 95 % confidence interval (CI) among cohort studies was 1.48 (1.25–1.75, p < 0.001). For case–control studies, the pooled odds ratio and 95 % CI was 1.72 (1.24–2.41, p = 0.001). No indication of significant heterogeneity across studies or publication bias was observed. In conclusion, maternal diabetes was significantly associated with a greater risk of ASD in the offspring.
KeywordsAutism spectrum disorders Diabetes Pregnancy
Autism diagnostic interview-revised
The autism diagnostic observation schedule
Autism spectrum disorders
The childhood autism rating scale
The diagnostic and statistical manual of mental disorders, fourth edition
International classification of diseases
- American Diabetes Association. (2004). Gestational diabetes mellitus. Diabetes Care, 27(Suppl 1), S88–S90.Google Scholar
- Autism and Developmental Disabilities Monitoring Network Surveillance Year 2008 Principal Investigators; Centers for Disease Control and Prevention. (2012). Prevalence of autism spectrum disorders–Autism and Developmental Disabilities Monitoring Network, 14 sites, United States, 2008. MMWR Surveill Summ, 61, 1–19.Google Scholar
- Bardenheier, B. H., Elixhauser, A., Imperatore, G., Devlin, H. M., Kuklina, E. V., Geiss, L. S., et al. (2013). Variation in prevalence of gestational diabetes mellitus among hospital discharges for obstetric delivery across 23 states in the United States. Diabetes Care, 36, 1209–1214.PubMedCrossRefGoogle Scholar
- Burstyn, I., Wang, X., Yasui, Y., Sithole, F., & Zwaigenbaum, L. (2011). Autism spectrum disorders and fetal hypoxia in a population-based cohort: accounting for missing exposures via Estimation-Maximization algorithm. BMC Medical Research Methodology, 11, 2.PubMedCentralPubMedCrossRefGoogle Scholar
- Elhameed, M. A. A., Elbaky, A. E. O. A., & Kamel, E. A. (2011). A controlled study of the risk factors and clinical picture of children with autism in an Egyptian sample. Egypt Journal of Neurology, Neurosurgery and Psychiatry, 48, 271–276.Google Scholar
- International Diabetes Federation. (2013) IDF Policy Briefing: Diabetes in Pregnancy: Protecting Maternal Health. Accessed July 10, 2013, from http://www.idf.org/sites/default/files/Policy_Briefing_DiabetesInPregancy.pdf.
- National Institute for Health and Care Excellence. (2009). NICE clinical guidelines 63: Diabetes in pregnancy: Management of diabetes and its complications from pre-conception to the postnatal period. Accessed July 10, 2013, from http://guidance.nice.org.uk/CG63.
- Okura, Y., Urban, L. H., Mahoney, D. W., Jacobsen, S. J., & Rodeheffer, R. J. (2004). Agreement between self-report questionnaires and medical record data was substantial for diabetes, hypertension, myocardial infarction and stroke but not for heart failure. Journal of Clinical Epidemiology, 57, 1096–1103.PubMedCrossRefGoogle Scholar
- Ornoy, A., Ratzon, N., Greenbaum, C., Wolf, A., & Dulitzky, M. (2001). School-age children born to diabetic mothers and to mothers with gestational diabetes exhibit a high rate of inattention and fine and gross motor impairment. Journal of Pediatric Endocrinology and Metabolism, 14(Suppl 1), 681–689.PubMedGoogle Scholar
- Stroup, D. F., Berlin, J. A., Morton, S. C., Olkin, I., Williamson, G. D., Rennie, D., et al. (2000). Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. The Journal of the American Medical Association, 283, 2008–2012.CrossRefGoogle Scholar
- Wells, G. A., Shea, B., O’Connell, D., Peterson, J., Welch, V., Losos, M., et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality if nonrandomized studies in meta-analyses. Accessed January 30, 2013, from http://www.ohri.ca/programs/clinical_epidemiology/oxford.htm.