While prenatal maternal infection has received attention as a preventable and treatable risk factor for autism, findings have been inconsistent. This paper presents the results of a meta-analysis to determine whether the weight of the evidence supports such an association. Studies with a categorical diagnosis of autism as the outcome and an assessment of its association with prenatal maternal infection or fever (or the data necessary to compute this association) were included. A total of 36 studies met these criteria. Two independent reviewers extracted data on study design, methods of assessment, type of infectious agent, site of infection, trimester of exposure, definition of autism, and effect size. Analyses demonstrated a statistically significant association of maternal infection/fever with autism in offspring (OR = 1.32; 95% CI = 1.20–1.46). Adjustment for evident publication bias slightly weakened this association. There was little variation in effect sizes across agent or site of infection. Small differences across trimester of exposure were not statistically significant. There was some evidence that recall bias associated with status on the outcome variable leads to differential misclassification of exposure status. Nonetheless, the overall association is only modestly reduced when studies potentially contaminated by such bias are removed. Although causality has not been firmly established, these findings suggest maternal infection during pregnancy confers an increase in risk for autism in offspring. Given the prevalence of this risk factor, it is possible that the incidence of autism would be reduced by 12%–17% if maternal infections could be prevented or safely treated in a timely manner.

中文翻译：

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产前母体感染与后代自闭症风险：一项荟萃分析

虽然产前母体感染作为自闭症可预防和可治疗的危险因素而受到关注，但研究结果并不一致。本文介绍了荟萃分析的结果，以确定证据的权重是否支持这种关联。以自闭症分类诊断为结果并评估其与产前母体感染或发烧的关联（或计算该关联所需的数据）的研究被纳入。共有 36 项研究符合这些标准。两名独立审查员提取了有关研究设计、评估方法、传染源类型、感染部位、接触三个月、自闭症定义和效应大小的数据。分析表明，母亲感染/发烧与后代自闭症之间存在统计学显着关联（OR = 1.32；95% CI = 1.20–1.46）。针对明显的发表偏倚进行的调整略微削弱了这种关联。不同药剂或感染部位的效应大小几乎没有差异。暴露的三个月之间的微小差异没有统计学意义。有一些证据表明，与结果变量状态相关的回忆偏差会导致暴露状态的不同错误分类。尽管如此，当删除可能被这种偏见污染的研究时，整体关联只会适度减少。尽管因果关系尚未确定，但这些研究结果表明，母亲在怀孕期间感染会增加后代患自闭症的风险。鉴于这种危险因素的普遍存在，