Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Sep 16;22(1):393.
doi: 10.1186/s12916-024-03617-3.

Prenatal environmental risk factors for autism spectrum disorder and their potential mechanisms

Chloe Love  1   2 , Luba Sominsky  1   2 , Martin O'Hely  2   3 , Michael Berk  2 , Peter Vuillermin  1   2   3 , Samantha L Dawson  4   5   6
Affiliations
Review

Prenatal environmental risk factors for autism spectrum disorder and their potential mechanisms

Chloe Love et al. BMC Med. .

Abstract

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that is globally increasing in prevalence. The rise of ASD can be partially attributed to diagnostic expansion and advocacy efforts; however, the interplay between genetic predisposition and modern environmental exposures is likely driving a true increase in incidence. A range of evidence indicates that prenatal exposures are critical. Infection during pregnancy, gestational diabetes, and maternal obesity are established risk factors for ASD. Emerging areas of research include the effects of maternal use of selective serotonin reuptake inhibitors, antibiotics, and exposure to toxicants during pregnancy on brain development and subsequent ASD. The underlying pathways of these risk factors remain uncertain, with varying levels of evidence implicating immune dysregulation, mitochondrial dysfunction, oxidative stress, gut microbiome alterations, and hormonal disruptions. This narrative review assesses the evidence of contributing prenatal environmental factors for ASD and associated mechanisms as potential targets for novel prevention strategies.

Keywords: Autism; Autism spectrum disorder; Biomarkers; Early life exposures; Epidemiology; Etiology; Mental health; Prenatal factors; Psychiatry.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
A schematic diagram summarizing prenatal environmental risk factors for autism spectrum disorder (ASD) and their potential mechanisms. From left to right, the left panel outlines genetic susceptibility and prenatal environmental risk factors such as infection during pregnancy, maternal obesity, diabetes, selective serotonin reuptake inhibitor (SSRI) and antibiotic use, and exposure to toxicants. The central panel details the underlying mechanisms for these risk factors, including inflammation, mitochondrial dysfunction, hormonal disruption, oxidative stress, and alterations in the gut microbiome that are associated with ASD development in offspring depicted in the panel on the right
See this image and copyright information in PMC

References

    1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. 2013.
    1. Hyman SL, Levy SE, Myers SM, Kuo DZ, Apkon S, Davidson LF, et al. Identification, evaluation, and management of children with autism spectrum disorder. Pediatrics. 2020;145(1):e20193447. 10.1542/peds.2019-3447 - DOI - PubMed
    1. Zeidan J, Fombonne E, Scorah J, Ibrahim A, Durkin MS, Saxena S, et al. Global prevalence of autism: a systematic review update. Autism Res. 2022;15(5):778–90. 10.1002/aur.2696 - DOI - PMC - PubMed
    1. Ratto AB, Kenworthy L, Yerys BE, Bascom J, Wieckowski AT, White SW, et al. What about the girls? Sex-based differences in autistic traits and adaptive skills. J Autism Dev Disord. 2018;48(5):1698–711. 10.1007/s10803-017-3413-9 - DOI - PMC - PubMed
    1. Hansen SN, Schendel DE, Parner ET. Explaining the Increase in the prevalence of autism spectrum disorders. JAMA Pediatr. 2015;169(1):56. 10.1001/jamapediatrics.2014.1893 - DOI - PubMed

Publication types