Abstract
Controversial results of the association between maternal body mass index (BMI) and risk of autism spectrum disorder (ASD) in offspring were reported among several studies. This meta-analysis was conducted to estimate the overall association between maternal BMI and risk of ASD in offspring. PubMed, EMBASE, Web of Science, and the Cochrane Library were searched until January 2016. Cohort and case-control studies addressing the association between maternal BMI and risk of ASD in offspring were included. We used random-effect models to estimate the summary relative risks (RRs), we also performed a dose-response meta-analysis to estimate the trend from the correlated log RR estimates across levels of BMI quantitatively. Totally, 6 cohort studies and 1 case-control study involving 8,403 cases and 509,167 participants were included for analysis. The summary RR (95% confidence interval) for ASD in offspring in relation to maternal underweight, overweight, and obesity vs. normal weight during pre-pregnancy or pregnancy, was 1.07 (0.93, 1.23), 1.28 (1.19, 1.36) and 1.36 (1.03, 1.78), respectively. A linear dose-response relationship was found, with a pooled RR of 1.16 (1.01, 1.33) for each 5 kg/m2. increment in maternal BMI. The present study suggests that excessive maternal BMI is associated with increased ASD risk in offspring.
Highlights
Autism spectrum disorders (ASD) are a group of complex neurodevelopmental disorders characterized by impairments in social interaction and communications, as well as restricted and repetitive behaviors[1]
There was no evidence of significant publication bias among the included studies according to Begg’s test and Egger’s test. In this meta-analysis of observational studies, we explored the effect of maternal body mass index (BMI) during pre-pregnancy or pregnancy on autism spectrum disorder (ASD) risk in offspring
Compared with children whose mothers were at normal weight, children born to overweight and obese mothers have a 28% and 36% higher risk of developing ASD, respectively
Summary
Autism spectrum disorders (ASD) are a group of complex neurodevelopmental disorders characterized by impairments in social interaction and communications, as well as restricted and repetitive behaviors[1]. While the study by Xaing et al.[7] and Garndner et al.[8] found a positive association between maternal obesity and ASD risk, the study by Moss et al.[9] found no statistically significant results. A recent meta-analysis by Li et al.[10] reviewed the studies regarding maternal obesity and ASD risk and found a positive relationship of maternal obesity with ASD risk. Li et al.[10] only focused on the effect of maternal obesity on ASD in offspring, but failed to fully assess the potential association of different category of BMI including overweight and underweight with ASD risk, and they failed to explore a possible dose-response relation of BMI and ASD risk because of the insufficient data. We aimed to systematically assess the association between maternal BMI (underweight, overweight and obesity) and ASD risk in offspring, trying to find a dose-response relation between them
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