Palabras clave
Factores ambientales
Embarazo
Epigenética
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Resumen
Objetivo: Investigar la influencia de factores ambientales y estilo de vida durante el embarazo en el desarrollo del TEA en 116 madres residentes en Imperatriz, Maranhão. Métodos: Se trata de una investigación de campo de tipo cuantitativa, descriptiva y exploratoria que utilizó muestreo por bola de nieve y aplicación de cuestionario validado. Resultados: El análisis descriptivo reveló baja exposición a sustancias tóxicas clásicas (tabaquismo 4,3%, alcohol 0,0%), pero alta prevalencia de factores de riesgo: fiebre gestacional (31,9%), ganancia excesiva de peso (37,9%), estrés (51,7%) y depresión (36,2%). Se observó una fuerte asociación entre depresión y estrés (χ² = 179,44; p < 0,0001), permaneciendo significativa después de la corrección de Bonferroni. Los factores protectores incluyeron suplementación con ácido fólico (73,3%) y atención prenatal adecuada (62,9%). Los resultados corroboran la hipótesis multifactorial del TEA, mediada por activación inmune materna, disfunción del eje HPA y alteraciones epigenéticas. Conclusión: Estos hallazgos tienen implicaciones para políticas de salud pública, reforzando la necesidad de prevención de infecciones gestacionales, detección de problemas de salud mental materna y manejo adecuado de la ganancia de peso gestacional.
Referencias
ABATE BB, et al. The association between maternal prenatal folic acid and multivitamin supplementation and autism spectrum disorders in offspring: An umbrella review. PLoS One, 2025; 18;20(11): e0334852.
ÁLVAREZ-MEJÍA D, et al. From Womb to Mind: Prenatal Epigenetic Influences on Mental Health Disorders. Int. J. Mol. Sci, 2025; 26: 6096.
BEVERSDORF DQ, et al. Prenatal Stress, Maternal Immune Dysregulation, and Their Association With Autism Spectrum Disorders. Curr Psychiatry Rep, 2018; 20(9): 76.
BORGES B, et al. Genética e epigenética do autismo: uma revisão bibliográfica. HPC Health and Primary Care, 2024; 2(1): 65.
BÖLTE S, et al. The contribution of environmental exposure to the etiology of autism spectrum disorder. Cell Mol Life Sci, 2019; 76(7): 1275-1297.
BOTELHO RM, et al. The Autism Spectrum Disorder and Its Possible Origins in Pregnancy. Int J Environ Res Public Health, 2024; 21(3): 244.
BRYNGE M, et al. Maternal infection during pregnancy and likelihood of autism and intellectual disability in children in Sweden: a negative control and sibling comparison cohort study. Lancet Psychiatry, 2022; 9(10): 782-791.
BRUNTON PJ, RUSSELL JA. Prenatal social stress in the rat programmes neuroendocrine and behavioural responses to stress in the adult offspring: sex-specific effects. J Neuroendocrinol, 2010; 22(4): 258-71.
CARPITA B, et al. Oxidative Stress, Maternal Diabetes, and Autism Spectrum Disorders. Oxid Med Cell Longev, 2018; 5: 3717215.
CHENG J, et al. Improving autism perinatal risk factors: A systematic review. Med Hypotheses, 2019; 127: 26-33.
COTTRELL EC, et al. Foetal and placental 11β-HSD2: a hub for developmental programming. Acta Physiol (Oxf), 2014; 210(2): 288-95.
CIERNIA AV, LASALLE J. The landscape of DNA methylation amid a perfect storm of autism aetiologies. Nat Rev Neurosci., 2016; 17(7): 411-23.
CUPERTINO MC, et al. Transtorno do espectro autista: uma revisão sistemática sobre aspectos nutricionais e eixo intestino-cérebro. ABCS Health Sciences, 2019; 44: 2.
FRANÇA AK, et al. Qualidade da dieta e fatores relacionados ao desenvolvimento de Diabetes mellitus gestacional em gestantes de alto risco de um hospital público do Nordeste brasileiro. Nutrición Clínica y Dietética Hospitalaria, 2017; 37(4): 118-126.
FRANCIS K, et al. Prevention in Autism Spectrum Disorder: A Lifelong Focused Approach. Brain Sci, 2021; 11(2): 151.
GENOVESE A, BUTLER MG. The Autism Spectrum: Behavioral, Psychiatric and Genetic Associations. Genes (Basel), 2023; 14(3): 677.
HODGES H, et al. Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation. Transl Pediatr, 2020; 9(Suppl 1): S55-S65.
HORNIG M, et al. Prenatal fever and autism risk. Mol Psychiatry, 2018; 23(3): 759-766.
HYMAN SL, et al. Council On Children With Disabilities, Section On Developmental And Behavioral Pediatrics. Identification, Evaluation, and Management of Children With Autism Spectrum Disorder. Pediatrics, 2020; 145(1): e20193447.
JESUS AJ. Avaliação de componentes de risco para o Transtorno do Espectro do Autismo em participantes do Projeto a Fada do Dente. 2020. Tese (Doutorado em Anatomia dos Animais Domésticos e Silvestres) - Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, 2020.
JUNQUEIRA AL, AMARAL CP. Gestação e Microbiota: o Intestino Materno como Guia do Desenvolvimento Cerebral. Brazilian Journal of Biological Sciences, 2025; 12(26): e437.
KALKBRENNER AE, et al. Maternal smoking during pregnancy and the prevalence of autism spectrum disorders, using data from the autism and developmental disabilities monitoring network. Environ Health Perspect., 2012; 120(7): 1042-8.
KAMINSKI VL, et al. Exploring potential impacts of pregnancy-related maternal immune activation and extracellular vesicles on immune alterations observed in autism spectrum disorder. Heliyon, 2023; 9(5): e15593.
KONG L, et al. Relationship of prenatal maternal obesity and diabetes to offspring neurodevelopmental and psychiatric disorders: a narrative review. Int J Obes, 2020; 44: 1981–2000.
LIU X, et al. Prenatal Folic Acid Supplements and Offspring's Autism Spectrum Disorder: A Meta-analysis and Meta-regression. J Autism Dev Disord, 2022; 52(2): 522-539.
MAIA CS, et al. Transtorno do espectro autista e a suplementação por ácido fólico antes e durante a gestação. Jornal Brasileiro de Psiquiatria, 2019; 68(4): 231-240.
MANDL S, et al. The effect of prenatal maternal distress on offspring brain development: A systematic review. Early Hum Dev, 2024; 192: 106009.
MASINI E, et al. An Overview of the Main Genetic, Epigenetic and Environmental Factors Involved in Autism Spectrum Disorder Focusing on Synaptic Activity. Int J Mol Sci, 2020; 21(21): 8290.
MEIRELES CS, et al. Fatores Pré Natais, Perinatais e Neonatais associados ao Nível de Suporte do Transtorno do Espectro Autista. ID onLine: Revista De Psicologia, 2025; 19(78): 91–109.
OBERLANDER TF, ZWAIGENBAUM L. Disentangling Maternal Depression and Antidepressant Use During Pregnancy as Risks for Autism in Children. JAMA, 2017; 317(15): 1533-1534.
PORTO DP, et al. Transtorno do espectro autista e fatores pré-natais: um estudo de caso controle. Revista Mineira de Enfermagem, 2025; 29: e52882.
RAI D, et al. Parental depression, maternal antidepressant use during pregnancy, and risk of autism spectrum disorders: population based case-control study. BMJ, 2013; 346: f2059.
SMITH SE, et al. Maternal immune activation alters fetal brain development through interleukin-6. J Neurosci, 2007; 27(40): 10695-702.
SU L, et al. Association Between Gestational Weight Gain and Autism Spectrum Disorder in Offspring: A Meta-Analysis. Obesity, 2020; 28(11): 2224-2231.
TICK B, et al. Heritability of autism spectrum disorders: a meta-analysis of twin studies. J Child Psychol Psychiatry, 2016; 57(5): 585-95.
TREMBLAY MW e JIANG YH. DNA Methylation and Susceptibility to Autism Spectrum Disorder. Annu Rev Med, 2019; 27(70): 151-166.
TUSA BS, et al. Maternal pre- and perinatal depression and the risk of autism spectrum disorders in offspring: systematic review and meta-analysis. BJPsych Open, 2025; 11(4): e117.
VINUTO J. A amostragem em bola de neve na pesquisa qualitativa: um debate em aberto. Temáticas, 2014; 22(44): 203–220.
WANG K, et al. Common genetic variants on 5p14.1 associate with autism spectrum disorders. Nature, 2009; 459: 528–533.
WORLD HEALTH ORGANIZATION. International statistical classification of diseases and related health problems, 2019; 10th rev., 2019 version. https://icd.who.int/browse10/2019/en.
WYRWOLL C, et al. Fetal brain 11β-hydroxysteroid dehydrogenase type 2 selectively determines programming of adult depressive-like behaviors and cognitive function, but not anxiety behaviors in male mice. Psychoneuroendocrinology. 2015; 59: 59-70.