Systematic Review of Prenatal Exposure to Endocrine Disrupting Chemicals and Autism Spectrum Disorder in Offspring

Epidemiological studies, which can have inherent methodological limitations, are used to study the relation between endocrine disrupting chemicals and autism spectrum disorder. The objective is to systematically review the treatment of methodological limitations and assess the quality and strength of the findings in the available literature. The quality and strength of the evidence were evaluated using the Navigation Guide Systematic Review Methodology. The overall quality and strength of the available studies were "moderate" and "limited," respectively. Risk of bias due to the methodological limitations regarding the exclusion of potential confounding factors and the lack of accuracy of exposure assessment methods were the most prevalent and were also considered to arrive at these results. The omnipresence of endocrine disrupting chemicals, their persistence and bioaccumulation, and the biological plausibility of the association between prenatal exposure to these and later development of autism spectrum disorder highlight the need to carry out well-designed epidemiological studies that overcome the methodological limitations observed in the currently available literature in order to be able to inform public policy to prevent exposure to these potentially harmful chemicals.