Autism Diagnosis in Children Following Intrauterine Growth Restriction: A Systematic Review

Abstract

Objectives: Autism spectrum disorder (ASD) is characterized by deficits in social interaction, communication impairments, and restricted and repetitive behavior. The etiological factors underlying ASD remain elusive, notwithstanding extensive research efforts, with prenatal and perinatal factors being a focus of investigation namely intrauterine growth restriction (IUGR). The aim of this study is to clarify the association between IUGR and the diagnosis of ASD in children. Methods: Following PRISMA guidelines, we conducted a systematic review by searching PubMed and Web of Science databases for studies correlating IUGR with ASD diagnosis in children. Data were extracted and analyzed systematically, as appropriate. A narrative synthesis of the selected articles was conducted due to the heterogeneous nature of IUGR definitions. Results: A total of eleven published articles were incorporated into this systematic review. Ten studies provided reported estimated effects after adjusting for covariables. Six articles demonstrate a positive association between IUGR and the occurrence of autism. The odds ratio values ranged from 1.42 (95% CI: 1.02-1.98) to 9.9 (95% CI, 3.3-30) across the studies demonstrating such a correlation. However, in five studies, a clear association was not demonstrated. Conclusion: This systematic review reveals a positive correlation between IUGR and ASD. However, further exploration of the underlying pathological mechanisms is crucial to develop effective strategies for preventing, screening, and treating ASD in IUGR affected children. Urgent action is imperative to address the widespread prevalence of ASD among children, given its multifactorial nature and lack of a definitive cause.