Pre-eclampsia and the risk of autism-spectrum disorder in offspring: meta-analysis

Background Evidence about the effect of intrauterine exposure to pre-eclampsia on offspring autism-spectrum disorder (ASD) is not well established. Aims To examine the association between pre-eclampsia and ASD. Method PubMed, Embase and PsycINFO databases were searched. Pooled relative risks (RR) with 95% confidence intervals were calculated. Subgroup and sensitivity analyses were performed. Heterogeneity was assessed using Cochran's Q-and the I-2-test. The presence of publication bias was evaluated by Egger's test and visual inspection of the symmetry in funnel plots. Results Ten studies meet the inclusion criteria. The risk of ASD was 32% higher in offspring who had intrauterine exposure to pre-eclampsia compared with those not exposed (RR = 1.32, 95% CI 1.20-1.45). Sensitivity analysis revealed consistent pooled estimates ranging from RR = 1.30 (95% CI 1.17-1.44) to RR = 1.37 (95% CI 1.26-1.48). We found no significant heterogeneity and evidence of publication bias. Conclusion Pre-eclampsia increased the risk of ASD in offspring. The finding suggests a need for early screening for ASD in offspring of women with pre-eclampsia. Copyright and usage (c) The Royal College of Psychiatrists 2018.