Marí-Bauset Salvador, Donat-Vargas Carolina, Llópis-González Agustín, Marí-Sanchis Amelia, Peraita-Costa Isabel, Llopis-Morales Juan, Morales-Suárez-Varela María
Unit of Public Health and Environmental Care, Department of Preventive Medicine, University of Valencia, Avenida Vicente Andrés Estellés s/n, Burjasot, 46100 Valencia, Spain.
Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13, 171 65 Solna, Sweden.
Children (Basel). 2018 Nov 23;5(12):157. doi: 10.3390/children5120157.
Exposure to environmental contaminants during pregnancy has been linked to adverse health outcomes later in life. Notable among these pollutants are the endocrine disruptors chemicals (EDCs), which are ubiquitously present in the environment and they have been measured and quantified in the fetus. In this systematic review, our objective was to summarize the epidemiological research on the potential association between prenatal exposure to EDCs and Autism Spectrum Disorder (ASD) published from 2005 to 2016. The Navigation Guide Systematic Review Methodology was applied. A total of 17 studies met the inclusion criteria for this review, including: five cohorts and 12 case-control. According to the definitions specified in the Navigation Guide, we rated the quality of evidence for a relationship between prenatal exposure to EDCs and ASD as "moderate". Although the studies generally showed a positive association between EDCs and ASD, after considering the strengths and limitations, we concluded that the overall strength of evidence supporting an association between prenatal exposure to EDCs and later ASD in humans remains "limited" and inconclusive. Further well-conducted prospective studies are warranted to clarify the role of EDCs on ASD development.
孕期接触环境污染物与日后的不良健康后果有关。这些污染物中值得注意的是内分泌干扰化学物质（EDCs），它们在环境中普遍存在，并且已在胎儿体内进行了测量和量化。在这项系统评价中，我们的目的是总结2005年至2016年发表的关于产前接触EDCs与自闭症谱系障碍（ASD）之间潜在关联的流行病学研究。采用了《导航指南》系统评价方法。共有17项研究符合本评价的纳入标准，包括：5项队列研究和12项病例对照研究。根据《导航指南》中规定的定义，我们将产前接触EDCs与ASD之间关系的证据质量评为“中等”。尽管这些研究总体上显示EDCs与ASD之间存在正相关，但在考虑了优势和局限性后，我们得出结论，支持产前接触EDCs与人类日后患ASD之间存在关联的证据总体强度仍然“有限”且尚无定论。有必要进一步开展精心设计的前瞻性研究，以阐明EDCs在ASD发展中的作用。
