The advent of next-generation sequencing technology, advanced imaging techniques, and cutting-edge molecular techniques for modeling ASD has allowed researchers to define ASD risk-related biological pathways and circuits that may, for the first time, unify the effects of disparate risk factors into common neurobiological mechanisms. The path from these mechanisms to biological treatments that improve the lives of individuals with autism remains unclear, but the cumulative output of multiple lines of research suggests that subtyping by genetic risk factors may be a particularly tractable way to capitalize on individual differences amenable to specific treatments.

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While prenatal maternal infection has received attention as a preventable and treatable risk factor for autism, findings have been inconsistent. This paper presents the results of a meta‐analysis to determine whether the weight of the evidence supports such an association. Studies with a categorical diagnosis of autism as the outcome and an assessment of its association with prenatal maternal infection or fever (or the data necessary to compute this association) were included. A total of 36 studies met these criteria. Two independent reviewers extracted data on study design, methods of assessment, type of infectious agent, site of infection, trimester of exposure, definition of autism, and effect size. Analyses demonstrated a statistically significant association of maternal infection/fever with autism in offspring (OR = 1.32; 95% CI = 1.20–1.46). Adjustment for evident publication bias slightly weakened this association. There was little variation in effect sizes across agent or site of infection. Small differences across trimester of exposure were not statistically significant. There was some evidence that recall bias associated with status on the outcome variable leads to differential misclassification of exposure status. Nonetheless, the overall association is only modestly reduced when studies potentially contaminated by such bias are removed. Although causality has not been firmly established, these findings suggest maternal infection during pregnancy confers an increase in risk for autism in offspring. Given the prevalence of this risk factor, it is possible that the incidence of autism would be reduced by 12%–17% if maternal infections could be prevented or safely treated in a timely manner. Lay Summary This study is a meta‐analysis of the association of maternal infection during pregnancy and subsequent autism in offspring. In combining the results from 36 studies of this association we find that a significant relationship is present. The association does not vary much across the types of infections or when they occur during pregnancy. We conclude that the incidence of autism could be substantially reduced if maternal infections could be prevented or safely treated in a timely manner.

The development of children and adolescents is characterized by abrupt discontinuities as well as continuous aspects of behavior such as individual temperament. The crucial task of the first year of life is the development and solidification of the attachment between infant and caretaker. Toddlers and adolescents tend to experience intense conflicts around autonomy and control that become resolved as they progress in the process of separation-individuation. The tasks of middle childhood include developing a sustained sense of mastery and competence, morality, and stable self-esteem; as ego functions grow and consolidate, children become increasingly able to tolerate frustration and delays in the gratification of their wishes and desires. Adolescence begins with puberty, the period of sexual maturation in which the primary sex organs develop and become capable of reproduction and secondary sex characteristics appear. Although adolescents tend to engage in risk-taking behaviors, the majority of adolescents maintain normal academic and social functioning; an adolescent whose rebelliousness includes severe disturbances in conduct, mood, or drug abuse should be evaluated for possible psychopathology requiring treatment. The main social developmental tasks for adults take place in the realms of work and intimate relationships.

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