Evidence map›Paper›PMID 40375705›Full record

SynthesisCurrent pediatric reviews2026

The Association between Prenatal Antibiotic Use and the Risk of Autism Spectrum Disorders among Children: An Updated Meta-Analysis.

Azam Maleki, Helen Behmanesh, Ensiyeh Jenabi

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Current pediatric reviews, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. The Neuroimmunology of Autism.Molecular neurobiology · 2025
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Azam MalekiSocial Determinants of Health Research Center, Health and Metabolic Diseases Research Institute, Zanjan University of Medical Sciences, Zanjan, Iran.
Helen BehmaneshAutism Spectrum Disorders Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
Ensiyeh JenabiAutism Spectrum Disorders Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.

Funding

Hamadan University of Medical Sciences 140310118903
6 · The paper itself

Abstract

backgroundStudies on prenatal antibiotic use and Autism Spectrum Disorder (ASD) risk have yielded inconsistent results.

aimThis study aimed to resolve these discrepancies by conducting a meta-analysis on the relationship between prenatal antibiotic use and ASD in children.

methodsA comprehensive search was conducted in four main databases: Medline (OVID) PubMed, Scopus, and Web of Science, up to August 1, 2024. The analysis employed random-effect models to estimate effect sizes, including hazard ratios (HR) and odds ratios (OR). Publication bias was assessed using Begg's test and Egger's regression test. Subgroup analyses explored variations in the association based on the trimester of pregnancy. The quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS).

resultsIn this meta-analysis, which included twelve studies with a total population of 6,264,831, prenatal antibiotic use was associated with an increased risk of Autism Spectrum Disorder (ASD). The estimated HR for this risk was 1.08 (95% CI: 1.05, 1.12), and the OR was 1.16 (95% CI: 1.09, 1.23), with no detected heterogeneity among studies. The analysis found no publication bias. Significant associations were observed for each trimester: first trimester (HR: 1.11; 95% CI: 1.04, 1.18), second trimester (HR: 1.10; 95% CI: 1.06, 1.14), and third trimester (HR: 1.09; 95% CI: 1.01, 1.18).

conclusionThe analysis showed that prenatal antibiotic use is a risk factor for ASD. Prenatal antibiotic use was associated with an increase in the risk of ASD across all trimesters of pregnancy. Future research should focus on elucidating the mechanisms underlying this association by examining the effects of specific antibiotic classes, dosages, and timing during critical developmental periods. Longitudinal studies with comprehensive control for confounding factors are essential for strengthening causal inferences and guiding clinical recommendations regarding antibiotic use during pregnancy.

Indexed as

Anti-Bacterial AgentsAutism Spectrum DisorderPrenatal Exposure Delayed EffectsChildFemaleHumansPregnancyRisk FactorsAnti-Bacterial Agentsantibiotic useAutism spectrum disorderfetal brain development.meta-analysispregnancyprenatal

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.