Prenatal vitamins and the risk of offspring autism spectrum disorder: systematic review and meta-analysis

Friel, C. , Leyland, A. H. , Anderson, J. J. , Havdahl, A., Borge, T., Shimonovich, M. and Dundas, R. (2021) Prenatal vitamins and the risk of offspring autism spectrum disorder: systematic review and meta-analysis. Nutrients, 13(8), 2558. (doi: 10.3390/nu13082558)

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Abstract

Prenatal nutrition is associated with offspring autism spectrum disorder (herein referred to as autism), yet, it remains unknown if the association is causal. Triangulation may improve causal inference by integrating the results of conventional multivariate regression with several alternative approaches that have unrelated sources of bias. We systematically reviewed the literature on the relationship between prenatal multivitamin supplements and offspring autism, and evidence for the causal approaches applied. Six databases were searched up to 8 June 2020, by which time we had screened 1309 titles/abstracts, and retained 12 articles. Quality assessment was guided using Newcastle–Ottawa in individual studies, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) for the body of evidence. The effect estimates from multivariate regression were meta-analysed in a random effects model and causal approaches were narratively synthesised. The meta-analysis of prenatal multivitamin supplements involved 904,947 children (8159 cases), and in the overall analysis showed no robust association with offspring autism; however, a reduced risk was observed in the subgroup of high-quality observational studies (RR 0.77, 95% CI (0.62, 0.96), I2 = 62.4%), early pregnancy (RR 0.76, 95% CI (0.58; 0.99), I2 = 79.8%) and prospective studies (RR 0.69, 95% CI (0.48, 1.00), I2 = 95.9%). The quality of evidence was very low, and triangulation was of limited utility because alternative methods were used infrequently and often not robustly applied.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Friel, Catherine and Shimonovich, Michal and Anderson, Dr Jana and Dundas, Professor Ruth and Leyland, Professor Alastair
Authors: Friel, C., Leyland, A. H., Anderson, J. J., Havdahl, A., Borge, T., Shimonovich, M., and Dundas, R.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO SPHSU
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Public Health
Journal Name:Nutrients
Publisher:MDPI
ISSN:2072-6643
ISSN (Online):2072-6643
Published Online:26 July 2021
Copyright Holders:Copyright © 2021 The Authors
First Published:First published in Nutrients 13(8): 2558
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
Inequalities in healthMedical Research Council (MRC)MC_UU_00022/2HW - MRC/CSO Social and Public Health Sciences Unit
Chief Scientist Office (CSO)SPHSU17
Medical Research Council (MRC)MC_ST_U18004