Child Health Research Unit, Barwon Health, Geelong, Australia.
The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, Australia.
BMC Med. 2024 Sep 16;22(1):393. doi: 10.1186/s12916-024-03617-3.
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.
自闭症谱系障碍（ASD）是一种神经发育障碍，其全球患病率正在不断上升。ASD 的上升部分归因于诊断范围的扩大和宣传工作的努力；然而，遗传易感性和现代环境暴露之间的相互作用可能导致发病率的真正增加。一系列证据表明，产前暴露是至关重要的。怀孕期间的感染、妊娠糖尿病和母亲肥胖是 ASD 的既定风险因素。新兴的研究领域包括母亲在怀孕期间使用选择性 5-羟色胺再摄取抑制剂、抗生素和接触有毒物质对大脑发育和随后的 ASD 的影响。这些风险因素的潜在途径尚不确定，有不同程度的证据表明免疫失调、线粒体功能障碍、氧化应激、肠道微生物组改变和激素紊乱。本综述评估了导致 ASD 的产前环境因素及其相关机制的证据，将其作为新的预防策略的潜在靶点。
