HYPERTENSIVE DISORDER OF PREGNANCY AND THE RISK OF AUTISM SPECTRUM DISORDER IN OFFSPRING: META-ANALYSIS

Abstract

Objective: Aim of this meta-analysis is to examine the association between Hypertensive Disorder of Pregnancy and ASD. ASD is the broad current designation for a group of conditions with deficits in social interaction and communication and RRBs(restricted repetitive behaviors), common severe pervasive neurodevelopmental disorder of undetermined etiology. Environmental exposures, especially pregnancy complications, have been increasingly recognized as a potential risk factor for ASD. Design and method: We conducted a systematic literature search onPubMed, 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 test. The presence of publication bias was evaluated by Egger's test and visual inspection of the symmetry in funnel plots. Results: A total of t welve studies meet the inclusion criteria with more than 307146 participant,including 6209 ASD. Subgroup analysis of clinical classification include: gestational hypertension, pre-eclampsia, chronic hypertension complicating pregnancy. The risk of ASD in pre-eclampsia is with OR 1.47 and CHP with OR 1.37 slightly higher than those of mothers with gestational hypertension OR 1.2. In consistence with most previous researches, higher ASD prevalence was observed in male than female,indicating a potential role for gender in the pathophysiology of ASD. The figure shows a Forest plot of the correlation between HDP and ASD Conclusions: This meta-analysis implies a possible link between Hypertensive Disorders of Pregnancy and the risk of Autism Spectrum Disorder in offspring. However, further investigation should be conducted to confirm this conclusion, and intensive prenatal surveillance and early prediction for ASD is needed.