Effect of Anesthesia During Pregnancy, Delivery, and Childhood on Autism Spectrum Disorder: A Systematic Review and Meta-analysis.

IF 3.2 2区 心理学 Q1 PSYCHOLOGY, DEVELOPMENTAL Journal of Autism and Developmental Disorders Pub Date : 2024-12-01 Epub Date: 2023-11-07 DOI:10.1007/s10803-023-06169-2
Simin He, Feixiang Zhou, Gang Tian, Yiran Cui, Yan Yan
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Abstract

To investigate the association between exposure to anesthesia during three periods of pregnancy, delivery, and childhood and autism spectrum disorder (ASD). PubMed, Scopus, Web of Science, Embase, Google Scholar, PsycArticles, and PsycINFO were searched from the date of database inception to 1 December 2022. Studies reported the association between exposure to anesthesia during pregnancy, delivery, and childhood and ASD were included. Extracted variables included hazard ratio (HR), relative risk or odds ratio, standard error, and 95% confidence interval (CI). Effect estimates were pooled using random-effects meta-analysis. In total, 16 studies including 8,156,608 individuals were included in the meta-analysis. Labor epidural anesthesia during delivery was associated with ASD in the general population (adjusted HR = 1.16, 95% CI, 1.06-1.28) but not in the sibling population (adjusted HR = 1.06, 95% CI, 0.98-1.15). Other anesthesia during delivery was not associated with ASD (general population: adjusted HR = 1.08, 95% CI, 0.99-1.17; sibling population: adjusted HR = 1.20, 95% CI, 0.81-1.79). Three studies suggested that exposure to anesthesia during pregnancy was associated with ASD in offspring (adjusted HR = 2.15, 95% CI, 1.32-3.48). There was no significant association between exposure to general anesthesia during childhood and ASD (adjusted HR = 1.02, 95% CI, 0.60-1.72). This meta-analysis did not confirm the association between exposure to anesthesia during labour and ASD. Previous observational studies used the neurotoxicity of anesthesia to biologically explain significant associations, but in fact different controls for confounding factors led to differences in associations. The evidence for pregnancy and childhood was limited given the small number of studies in these periods.

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妊娠、分娩和儿童期麻醉对自闭症谱系障碍的影响:系统综述和荟萃分析。
研究妊娠、分娩和儿童三个时期的麻醉暴露与自闭症谱系障碍(ASD)之间的关系。PubMed、Scopus、Web of Science、Embase、Google Scholar、PsycArticles和PsycINFO从数据库创建之日至2022年12月1日进行了搜索。研究报告了妊娠、分娩和儿童期暴露于麻醉与ASD之间的关系。提取的变量包括风险比(HR)、相对风险或比值比、标准误差和95%置信区间(CI)。使用随机效应荟萃分析汇总效应估计。荟萃分析共纳入16项研究,包括8156608名个体。分娩期间硬膜外分娩麻醉与普通人群中的ASD相关(调整HR = 1.16,95%CI,1.06-1.28),但在兄弟姐妹群体中没有(调整HR = 1.06,95%CI,0.98-1.15)。分娩期间的其他麻醉与ASD无关(一般人群:调整HR = 1.08,95%可信区间,0.99-1.17;同胞群体:调整后的HR = 1.20,95%CI,0.81-1.79)。三项研究表明,妊娠期暴露于麻醉与后代ASD相关(调整HR = 2.15,95%CI,1.32-3.48)。儿童期全身麻醉暴露与ASD之间没有显著关联(调整HR = 1.02,95%CI,0.60-1.72)。该荟萃分析未证实分娩期间暴露于麻醉与ASD之间的相关性。先前的观察性研究使用麻醉的神经毒性来从生物学上解释显著的关联,但事实上,对混杂因素的不同控制导致了关联的差异。鉴于这些时期的研究数量很少,关于怀孕和儿童期的证据有限。
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来源期刊
CiteScore
8.00
自引率
10.30%
发文量
433
期刊介绍: The Journal of Autism and Developmental Disorders seeks to advance theoretical and applied research as well as examine and evaluate clinical diagnoses and treatments for autism and related disabilities. JADD encourages research submissions on the causes of ASDs and related disorders, including genetic, immunological, and environmental factors; diagnosis and assessment tools (e.g., for early detection as well as behavioral and communications characteristics); and prevention and treatment options. Sample topics include: Social responsiveness in young children with autism Advances in diagnosing and reporting autism Omega-3 fatty acids to treat autism symptoms Parental and child adherence to behavioral and medical treatments for autism Increasing independent task completion by students with autism spectrum disorder Does laughter differ in children with autism? Predicting ASD diagnosis and social impairment in younger siblings of children with autism The effects of psychotropic and nonpsychotropic medication with adolescents and adults with ASD Increasing independence for individuals with ASDs Group interventions to promote social skills in school-aged children with ASDs Standard diagnostic measures for ASDs Substance abuse in adults with autism Differentiating between ADHD and autism symptoms Social competence and social skills training and interventions for children with ASDs Therapeutic horseback riding and social functioning in children with autism Authors and readers of the Journal of Autism and Developmental Disorders include sch olars, researchers, professionals, policy makers, and graduate students from a broad range of cross-disciplines, including developmental, clinical child, and school psychology; pediatrics; psychiatry; education; social work and counseling; speech, communication, and physical therapy; medicine and neuroscience; and public health.
期刊最新文献
Correction: Caregivers' Assessment of the Sensory Processing Patterns Exhibited by Children with Autism in the Gulf Region. Breastfeeding Journeys: Comparing Mothers' Experiences with Autistic and Neurotypical Infants. Decreasing Agitation in Neurodiverse Patients with Mental Health Concerns. Correction: The Chinese 10-Item Empathy Quotient and Systemising Quotient-Revised: Internal Consistency, Test-Retest Reliability, Known-Groups Validity, and Sex Differences in Autistic and Non-Autistic Adults. Growth Trajectories of Joint Attention and Play as Predictors for Language in Young Children at Elevated Likelihood for Autism.
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