Objective To assess the association of maternal and environmental factors with the risk of autism in children, thereby informing strategies for prevention and early intervention. Methods A comprehensive search was conducted for case-control studies in both Chinese and English, utilizing databases including Wanfang, VIP, CNKI, and PubMed.The quality of the retrieved literature was rigorously assessed, and relevant risk factors were extracted for analysis.Statistical evaluation was performed using Review Manager 5.3, focusing on odds ratios (OR) and 95% confidence intervals (CI) as primary measures. Results Fifteen articles, encompassing a total of 1 758 cases in the observation group and 7 848 healthy children in the control group from six countries, were included in the final analysis.The Results indicated significant associations between autism and several factors, including paternal age over 35 years old (OR=2.60, 95%CI:1.58 - 4.61), maternal emotional disorders during pregnancy (anxiety, depression, stress) (OR=3.06, 95%CI:2.23 - 4.20), maternal smoking (active and passive) during pregnancy (OR=3.57, 95%CI:2.68 - 4.75), paternal introversion (OR=2.55, 95%CI:1.35 - 4.78), history of maternal induced abortion (OR=3.76, 95% CI:2.54 - 5.57), and maternal occupational exposure to toxins (OR=2.24, 95%CI:1.35 - 3.70).Additional significant associations were observed with maternal pregnancy-related diseases (hypertension, diabetes, hypothyroidism, etc.) (OR=2.47, 95%CI:1.22 - 4.98), maternal exposure to ionizing radiation (including frequent computer use) during the first six months of pregnancy (OR=2.35, 95%CI:1.39 - 3.98), family history of mental illness (OR=8.26, 95%CI:2.90 - 23.50), and maternal use of certain medications (anti-infective drugs, hormones) (OR=5.24, 95%CI:2.50 - 10.96). Conclusions The findings suggest a complex interplay of genetic, environmental and maternal health factors in the etiology of childhood autism.Early identification and mitigation of these risk factors, alongside vigilant monitoring during pregnancy, are imperative for reducing the incidence of autism and improving child health outcomes.
Key words
childhood autism /
environmental factors /
maternal factors /
Meta-analysis
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