Maternal and cord blood lipidomics as predictors of autism spectrum disorders: A systematic review
Bibliographic record
Abstract
Background: Lipid metabolism is integral to neurodevelopment, contributing to neuronal membrane integrity, myelination, and signaling processes. Recent evidence indicates that disruptions in maternal and perinatal lipidomic profiles may be linked to an increased risk of autism spectrum disorders (ASD). To date, no systematic review has synthesized findings from human cohort studies examining lipidomic biomarkers during pregnancy or at birth in relation to subsequent ASD development. Methods: We systematically searched PubMed/MEDLINE, Embase, Scopus, Web of Science, Google Scholar, PsycINFO, CINAHL, and grey literature sources from inception to September 2025 for studies assessing maternal lipidomics during pregnancy, postpartum lipid profiles, or cord/neonatal lipidomics in relation to ASD diagnoses or autistic traits measured in offspring. Eligible study designs included prospective cohorts and nested case-control studies. Data extraction followed a standardized template, and methodological quality was appraised using the Newcastle-Ottawa Scale (NOS). Findings were synthesized narratively given heterogeneity in biospecimen timing, lipidomic platforms, and outcome measures. The protocol was registered with PROSPERO (CRD420251152074). Results: Nine prospective studies met the inclusion criteria. Maternal lipidomics during pregnancy indicated that lower ω-3 to ω-6 polyunsaturated fatty acid ratios and deficiencies in docosahexaenoic acid were associated with increased autistic traits or ASD with intellectual disability. Postpartum maternal lipid profiles showed that low low-density lipoprotein (LDL) cholesterol predicted greater ASD risk. Cord blood and neonatal lipidomics implicated acylcarnitines, sphingomyelins, and arachidonic acid-derived oxylipins in later ASD symptoms, with some studies demonstrating moderate predictive accuracy (AUROC ranging from 0.71 to 0.85) using machine learning approaches. Overall, recurrent disturbances in fatty acid metabolism, mitochondrial β-oxidation, and inflammatory lipid mediators were observed. Conclusions: Prospective evidence supports an association between maternal and neonatal lipidomic alterations and ASD risk, suggesting potential early biomarkers. However, heterogeneity across studies and reliance on single-timepoint measures limit comparability. Standardized lipidomic protocols, longitudinal sampling, and replication in diverse cohorts are needed to establish clinical utility and inform prevention strategies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.028 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.007 |
| Bibliometrics | 0.009 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".