Is There an Association between Fetal Distress and Autism Spectrum Disorders (ASD) among Children? A Systematic Review and Meta-Analysis

Background Evidence regarding the relation between fetal distress and development of autism spectrum disorders (ASD) among children is rare. Therefore, this systematic review and systematic review and meta-analysis was conducted to assess the relation between fetal distress and ASD among children with stronger evidence. Materials and Methods: In this systematic review and meta-analysis, Medline, Scopus, Web of Science and Google Scholar were searched using the relevant keywords on observational studies from inception to October 2020 without any language restriction by two independent authors. The pooled odds ratios (OR), and 95% confidence intervals (CI( were calculated from eligible studies used as random effect estimates of association among included studies. The inconsistency across results of studies was quantified using I-2 statistic. Data were analyzed using Stata software version 13.0. Results: From 341 identified studies, eight studies (684,262 individuals) were included in the meta-analysis. The pooled estimates of OR did not show a significant association between fetal distress and the risk of ASD among children, respectively (OR = 1.27, 95% CI = 0.88 to 1.67). There was medium heterogeneity among included studies (I-2=50.4%, P=0.049). Conclusion Our findings showed that fetal distress was not a risk factor for ASD among children. In a comparison to the previous meta-analysis, this study provides the most up-to-date evidence supporting a lack of significant association between fetal distress and ASD. Here, the association between fetal distress and ASD is still under discussion so that, further researches and umbrella reviews are needed.