Clin Exp Pediatr > Accepted Articles
DOI: https://doi.org/10.3345/cep.2021.01872    [Accepted]
Published online July 19, 2022.
Not breastfeeding and risk of autism spectrum disorders among children: a meta-analysis
Ensiyeh Jenabi1  , Saeid Bashirian2, Amir Mohammad Salehi3, Salman Khazaei4
1Mother and Child Care Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
2Autism Spectrum Disorders Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
3Medical Student, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
4Autism Spectrum Disorders Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
Correspondence: 
Ensiyeh Jenabi, Email: en.jenabi@yahoo.com
Received: 22 December 2021   • Revised: 11 May 2022   • Accepted: 6 June 2022
Abstract
To our knowledge, this is the first meta-analysis of the association of not breastfeeding and the risk of autism spectrum disorder (ASD) based on observational studies. Three databases (PubMed, Web of Science, and Scopus) were systematically searched until December 2021. Heterogeneity was determined using the chi-square test and its quantity was measured using the I2 statistic. The Begg’s line regression test was used to assess publication bias. A random-effects model was used to analyze the data. Seven studies were included in this meta-analysis. The total study population included 3,270 individuals. According to the random-effects model, the estimated odds ratio of the risk of ASD associated with not breastfeeding was 1.81 (95% confidence interval, 1.35–2.27; I2=0.0%). The results of the included studies were homogeneous. Our findings showed that not breastfeeding is a risk factor for ASD. These results suggest the importance of breastfeeding in decreasing the risk of ASD in children.
Key Words: Autism spectrum disorders, Breastfeeding, Child, Meta-analysis


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