Prenatal maternal stress and risk of neurodevelopmental disorders in the offspring: a systematic review and meta-analysis

Soc Psychiatry Psychiatr Epidemiol. 2019 Nov;54(11):1299-1309. doi: 10.1007/s00127-019-01745-3. Epub 2019 Jul 20.

Abstract

Purpose: Exposure to prenatal stress has been reported to affect the risk of adverse neurodevelopmental outcomes in the offspring; however, there is currently no clear consensus. The aim of this systematic review and meta-analysis was to examine the existing literature on the association between prenatal stress and autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) in the offspring.

Methods: Based on a registered protocol, we searched several electronic databases for articles in accordance with a detailed search strategy. We performed this study following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA).

Results: Prenatal stress was significantly associated with an increased risk of both ASD (pooled OR 1.64 [95% CI 1.15-2.34]; I2 = 90%; 15 articles) and ADHD (pooled OR 1.72 [95% CI 1.27-2.34]; I2 = 85%; 12 articles).

Conclusions: This study suggests that prenatal stress may be associated with ASD and ADHD; however, several limitations in the reviewed literature should be noted including significant heterogeneity and there is a need for carefully controlled future studies in this area.

Keywords: Attention-deficit/hyperactivity disorder; Autism spectrum disorder; Mental health; Pregnancy; Prenatal maternal stress.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Attention Deficit Disorder with Hyperactivity / psychology
  • Autism Spectrum Disorder / psychology
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Maternal Exposure / adverse effects*
  • Neurodevelopmental Disorders / psychology*
  • Pregnancy
  • Pregnancy Complications / psychology*
  • Prenatal Exposure Delayed Effects / psychology*
  • Stress, Psychological / complications*