Human Reproduction Archives
Human Reproduction Archives
Review Article Reproductive Health


Luiza Emylce Pelá Rosado, Matheus Maia Garcia, Ana Cláudia do Nascimento Coutinho

Downloads: 1
Views: 53


Autistic Spectrum Disorder (ASD) is understood as a group of phenotypic conditions that have in common changes in the development of sociability and communication. Methods: This is a narrative review aiming to update the proposed theme. We used population - based studies such as cohorts, case - control studies as well as previous reviews, published at PubMed, SciELO-LILACS and Cochrane library between January 2018 and May 2019. We used the descriptors: autistic disorder, combined with pregnancy and the MeSH Terms: Autism Spectrum Disorder, combined with pregnancy. 52 studies were selected and, after exclusion criteria, 34 composed this review. Results/Conclusion: Throughout the analysis of results, we could observe, despite of genetic causes, that during the whole pregnancy and postpartum period, the interaction of the pregnant women with the environment and some risk factors that may interfere in maternal-fetal health, such as parent’s age, race, being migrants, hypertension, diabetes, use of anticonvulsants, acetaminophen, fetal growth restriction, pre-eclampsia, excessive weight gain and labor complications that showed association to ASD, while alcohol, smoking, folic acid use and vaccination had no association. It’s up to health professionals to educate themselves even more so as to anticipate, as far as possible, the disorder and know how to deal with special children, free from prejudices and stigmata.


autistic spectrum disorder, autism, pregnancy, growth and development.


1. Polo-Kantola P, Lampi KM, Hinkka-Yli-Salomäki S, Gissler M, Brown AS, Sourander A. Obstetric risk factors and autism spectrum disorders in Finland. J Pediatr. 2014;164(2):358-65. PMid:24183209.

2. Hallmayer J, Cleveland S, Torres A, Phillips J, Cohen BAB, Torigoe BAT, et al. Genetic heritability and shared environmental factors among twin pairs with autism. Arch Gen Psychiatry. 2011;68(11):1095-102. PMid:21727249.

3. Froehlich-Santino W, Tobon AL, Cleveland S, Torres A, Phillips J, Cohen B, et al. Prenatal and perinatal risk factors in a twin study of autism spectrum disorders. J Psychiatr Res. 2014;54:100-8. PMid:24726638.

4. Pignatari G. CDC divulga novos números de autismo nos EUA: 1 para 59 [Internet]. São Paulo: Tiismo; 2018 [cited 2018 Aug 6]. Available from:

5. Fombonne E. Epidemiology of pervasive developmental disorders. Pediatr Res. 2009;65(6):591-8. PMid:19218885.

6. Klin A. Autism and Asperger syndrome: an overview. Rev Bras Psiquiatr. 2006;28(Supl I):S3-11. PMid:16791390.

7. Wang C, Geng H, Liu W, Zhang G. Prenatal, perinatal, and postnatal factors associated with autism: a meta-analysis. Medicine. 2017;96(18):e6696. PMid:28471964.

8. Abdullahi I, Wong K, Mutch R, Glasson EJ, De Klerk N, Cherian S, et al. Risk of developmental disorders on children of immigrant mothers: a population-based data linkage evaluation. J Pediatr. 2019;204(3):275-84.e3. PMid:30293641.

9. Brimacombe M, Ming X, Lamendola M. Prenatal and birth complications in autism. Matern Child Health J. 2007;11(1):73-9. PMid:17053965.

10. Mann JR, McDermott S, Bao H, Hardin J, Gregg A. Pre-eclampsia, birth weight, and autism spectrum disorders. J Autism Dev Disord. 2010;40(5):548-54. PMid:19936906.

11. Surén P, Roth C, Bresnahan M, Haugen M, Hornig M, Hirtz D, et al. Association between maternal use of folic acid supplements and risk of autism spectrum disorders in children. JAMA. 2013;309(6):570-7. PMid:23403681.

12. Steenweg-de Graaff J, Ghassabian A, Jaddoe VW, Tiemeier H, Roza SJ. Folate concentrations during pregnancy and autistic traits in the offspring: the generation R study. Eur J Public Health. 2015;25(3):431-3. PMid:25085472.

13. Rai D, Lee BK, Dalman C, Newschaffer C, Lewis G, Magnusson C. Antidepressants during pregnancy and autism in offspring: population based cohort study. BMJ. 2017;358:j2811. PMid:28724519.

14. Croen LA, Grether JK, Yoshida CK, Odouli R, Hendrick V. Antidepressant use during pregnancy and chilhood autism spectrum disorders. Arch Gen Psychiatry. 2011;68(11):1104-12. PMid:21727247.

15. Sørensen MJ, Gronborg TK, Christensen J, Parner ET, Vestergaard M, Schendel D, et al. Antidepressant exposure in pregnancy and risk of autism spectrum disorders. Clin Epidemiol. 2013;5:449-59. PMid:24255601.

16. Hviid A, Melbye M, Pasternak B. Use of selective serotonin reuptake inhibitors during pregnancy and risk of autism. N Engl J Med. 2013;369(25):2406-15. PMid:24350950.

17. Christensen J, Gronborg TK, Sorensen MJ, Schendel D, Parner ET, Pedersen LH, et al. Prenatal valproate exposure and risk of autism spectrum disorders and childhood autism. JAMA. 2013;309(16):1696-703. PMid:23613074.

18. Meador KJ, Baker GA, Browning N, Cohen MJ, Bromley RL, Clayton-Smith J, et al. Fetal antiepileptic drug exposure and cognitive out comes at age 6 years (NEAD study): a prospective observation al study. Lancet Neurol. 2013;12(3):244-52. PMid:23352199.

19. Andrade C. Use of acetaminophen (paracetamol) during pregnancy and the risk of autism spectrum disorder in the offspring. J Clin Psychiatry. 2016;77(2):e152-4. PMid:26930528.

20. Liew Z, Ritz B, Virk J, Olsen J. Maternal use of acetaminophen during pregnancy and risk of autism spectrum disorders in childhood: a danish national birth cohort study. Autism Res. 2016;9(9):951-8. PMid:26688372.

21. Albert O, Desdoits-Lethimonier C, Lesné L, Legrand A, Guillé F, Bensalah F, et al. Paracetamol, aspirin and indomethacin display endocrine disrupting properties in the adult humantestis in vitro. Hum Reprod. 2013;28(7):1890-8. PMid:23670170.

22. Frye CA, Bo E, Calamandrei G, Calzá L, Dessi-Fulgheri F, Fernandéz M, et al. Endocrine disrupters: a review of some sources, effects, and mechanisms of actions on behavior and neuroendocrine systems. J Neuroendocrinol. 2012;24(1):144-59. PMid:21951193.

23. Ghanizadeh A. Acetaminophen may mediate oxidative stress and neurotoxicity in autism. Med Hypotheses. 2012;78(2):351. PMid:22154541.

24. DeStefano F, Shimabukuro TT. The MMR vaccine and autism. Annu Rev Virol. 2019;6(1):585-600. PMid:30986133.

25. Eliasen M, Tolstrup JS, Nybo Andersen AM, Grønbaek M, Olsen J, Strandberg-Larsen K. Prenatal alcohol exposure and autistic spectrum disorders- a population-based prospective study of 80 552 children and their mothers. Int J Epidemiol. 2010;39(4):1074-81. PMid:20371506.

26. Gupta KK, Gupta VK, Shirasaka T. An update on fetal alcohol syndrome-pathogenesis, risks, and treatment. Alcohol Clin Exp Res. 2016;40(8):1594-602. PMid:27375266.

27. Jung Y, Lee AM, McKee SA, Picciotto MR. Maternal smoking and autism spectrum disorder: meta-analysis with population smoking metrics as moderators. Sci Rep. 2017;7(1):4315. PMid:28659613.

28. Curran EA, O’Keeffe GW, Looney AM, Moloney G, Hegarty SV, Murray DM, et al. Exposure to hypertensive disorders of pregnancy increases the risk of autism spectrum disorder in affected offspring. Mol Neurobiol. 2018;55(7):5557-64. PMid:28975539.

29. Xiang AH, Wang X, Martinez MP, Walthall JC, Curry ES, Page K, et al. Association of maternal diabetes with autism in offspring. JAMA. 2015;313(14):1425-34. PMid:25871668.

30. Xu G, Jing J, Bowers K, Liu B, Bao W. Maternal diabetes and the risk of autism spectrum disorders in the offspring: a systematic review and meta-analysis. J Autism Dev Disord. 2014;44(4):766-75. PMid:24057131.

31. Xiang AH, Wang X, Martinez MP, Page K, Buchanan TA, Feldman RK. Maternal type 1 diabetes and risk of autism in offspring. JAMA. 2018;320(1):89-91. PMid:29936530.

32. Windham GC, Anderson M, Lyall K, Daniels JL, Kral TVE, Croen LA, et al. Maternal pre-pregnancy body mass index and gestacional weight gain in relation to autism spectrum disorder and other developmental disorders in offspring. Autism Res. 2019;12(2):316-27. PMid:30575327.

33. Smallwood M, Sareen A, Baker E, Hannusch R, Kwessi E, Williams T. Increased risk of autism development in children whose mothers experienced birth complications or received labor and delivery drugs. ASN Neuro. 2016;8(4):1-7. PMid:27511908.

34. Willfors C, Carlsson T, Anderlid B-M, Nordgren A, Kostrzewa E, Berggren S, et al. Medical history of discordant twins and environment al etiologies of autism. Transl Psychiatry. 2017;7(1):e1014. PMid:28140403.

5f440ea60e8825392c0d2b94 hra Articles
Links & Downloads

Hum Reprod Arch

Share this page
Page Sections