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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV0181

Association between maternal thyroid dysfunction during pregnancy and autism spectrum disorder in offspring: a systematic review and meta-analysis

ASSOCIATION OF MATERNAL THYROID DYSFUNCTION DURING PREGNANCY WITH AUTISM SPECTRUM DISORDER IN THE OFFSPRING: A SYSTEMATIC REVIEW AND META-ANALYSIS

The observed associations between maternal thyroid dysfunction and autism in offspring largely disappear after adjustment for familial confounding.

The aim was to determine which associations between maternal thyroid dysfunction during pregnancy and clinically diagnosed autism spectrum disorder (ASD) in offspring persist after bias adjustment; the rationale was that evidence from sibling comparisons suggests that familial confounding may explain much of this association. PubMed, Embase, and the Cochrane Library were searched through March 2026; of 371 records, 312 were screened, and 14 reports were included. Random-effects models pooled six reports on hypothyroidism and four on hyperthyroidism; other domains were presented narratively, and assessments used ROBINS-E and GRADE. Triangulation was prespecified; E-values and probabilistic quantitative bias analysis (QBA; 50,000 draws per domain) were conducted as exploratory post hoc analyses. The observed results were: for hypothyroidism, a hazard ratio (HR) of 1.34 (95% CI 1.22 to 1.46; 6 reports; I² = 39%; P = 0.14; low certainty); for hyperthyroidism, an HR of 1.17 (95% CI 1.07 to 1.28; 4 reports; I² = 0%; P = 0.57; low certainty); and for TPO antibody positivity, an odds ratio (OR) of 1.78 (95% CI 1.16 to 2.75; single study; very low certainty). Median adjusted estimates from the primary QBA were an HR of 0.96 for hypothyroidism (P[HR > 1] = 36.8%), an HR of 0.84 for hyperthyroidism (P[HR > 1] = 8.1%), and an OR of 1.27 for TPO antibody positivity (P[OR > 1] = 83.1%), with lower-bound E-values of 1.74, 1.34, and 1.59, respectively. In conclusion, the associations with clinical thyroid dysfunction are vulnerable to plausible familial confounding; although TPO antibody positivity appears more robust, it is supported by a single study and very low-certainty evidence. These findings do not provide a basis for widespread screening to prevent ASD; priority should be given to replication studies using sibling-comparison or paternal negative-control designs. None of the included studies used sibling comparisons or paternal negative controls; familial confounding was modeled rather than ruled out by design.

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