Steroid hormone pathways, vitamin D and autism: a systematic review.

Anouck Amestoy, Claire Baudrillard, Kellen Briot, Adrien Pizano, Manuel Bouvard, Meng-Chuan Lai
J Neural Transm. 2023-02-08; 130(3): 207-241
DOI: 10.1007/s00702-022-02582-6

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https://www.bordeaux-neurocampus.fr/12464

1. J Neural Transm (Vienna). 2023 Mar;130(3):207-241. doi:
10.1007/s00702-022-02582-6. Epub 2023 Feb 8.

Amestoy A(1)(2), Baudrillard C(3), Briot K(3), Pizano A(3), Bouvard M(4)(3), Lai
MC(5)(6)(7)(8)(9).

Author information:
(1)Aquitaine Institute for Cognitive and Integrative Neuroscience, UMR 5287,
University of Bordeaux, CNRS, INCIA, Bordeaux, France. .
(2)Centre Hospitalier Charles-Perrens, Pôle Universitaire de Psychiatrie de
L’enfant Et de L’adolescent, Bordeaux Cedex, France. .
(3)Centre Hospitalier Charles-Perrens, Pôle Universitaire de Psychiatrie de
L’enfant Et de L’adolescent, Bordeaux Cedex, France.
(4)Aquitaine Institute for Cognitive and Integrative Neuroscience, UMR 5287,
University of Bordeaux, CNRS, INCIA, Bordeaux, France.
(5)The Margaret and Wallace McCain Centre for Child, Youth & Family Mental
Health and Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental
Health Research Institute, Centre for Addiction and Mental Health, Toronto,
Canada.
(6)Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto,
Toronto, Canada.
(7)Department of Psychiatry and Autism Research Unit, The Hospital for Sick
Children, Toronto, Canada.
(8)Autism Research Centre, Department of Psychiatry, University of Cambridge,
Cambridge, UK.
(9)Department of Psychiatry, National Taiwan University Hospital and College of
Medicine, Taipei, Taiwan.

The origins of the male preponderance in autism incidence remain unclear. The
idea that perinatal factors associated with sex differentiation (e.g., steroid
hormone pathways) may increase the possibility of the emergence of autism is
complementary to the hypothesis that female individuals are intrinsically less
likely to develop autism. Empirical evidence for the mechanistic roles of in
utero steroid hormones in autism etiology is accumulating but inconsistent. We
conducted a systematic review using rigorous criteria for the measurements of
steroids and vitamin D exposure, to summarize the potential contributing roles
of prenatal and early postnatal steroids and vitamin D alterations to the
emergence of autism. We searched PubMed, PsychInfo, Scopus, and included 22
studies for qualitative synthesis. Among them, six studies examined the
association of autism diagnoses in offspring and levels of steroids and
precursor steroid hormones in the fetal environment, eight studies examined the
associations between autism and maternal and fetal blood vitamin D levels during
pregnancy and at birth, and eight studies examined the associations between
offspring autism diagnoses and maternal hyperandrogenemia diagnosed before
pregnancy. We identified promising and complex results regarding the relations
between steroid metabolism and autism. The interpretation of findings was
limited by the mostly observational study designs, insufficient investigation of
the effects of offspring sex, confounders and their cumulative effects on the
development of the child, and unclear impact of the timing of steroids exposure
and their effects on fetal neurodevelopment.