1. Bonthala I, Chadubudhi S, Linga S, Saheb SK. A Multimodal AI Framework for Early Autism Identification Using CbRNN-Ensemble Modelling and Advanced NCIAPPF-Based Temporal Encoding. Int J Dev Neurosci;2026 (Apr);86(2):e70117.

To improve child developmental results and enable prompt interventions, early identification of autism spectrum disorder (ASD) is crucial. Conventional diagnostic instruments, while clinically standardized, remain constrained by subjectivity, limited scalability and dependence on expert evaluation. This study introduces AutiScan, an AI-driven framework that integrates a Convolution-based Recurrent Neural Network Ensemble Model (CbRNN-EM) with the neural context-integrated adaptive reprocessing and pattern filtering (NCIAPPF) technique for capturing temporal dynamics of neural encoding. The proposed system analyses multimodal data including facial expressions, eye-gaze patterns, speech prosody and behavioural cues to extract spatial, emotional and sequential features relevant to early ASD markers. NCIAPPF enhances preprocessing by adaptively filtering noise, normalizing multimodal signals and preserving fine-grained temporal dependencies essential for robust pattern recognition. The fused representations are classified using an ensemble layer, achieving superior accuracy compared with traditional deep learning and machine learning prototypes. The results of the experiments show that AutiScan offers a dependable, scalable and comprehensible early ASD screening tool, underscoring the opportunity for practical clinical and educational implementation.

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2. Bowden N, Anns F, Clendon S, Dacombe J, Meehan L, Vu H, Woodford E, McLay L. Enrolment, attendance, and education resourcing and support among 5-12 year old autistic students in Aotearoa New Zealand: a nationwide cross-sectional study. Int J Popul Data Sci;2026;10(2):3362.

INTRODUCTION: Participation in education underpins positive lifelong outcomes, yet Autistic children often encounter barriers to enrolment, attendance, and access to support. Evidence indicates that systemic challenges such as inadequate support, limited autism-specific teacher training, and restricted access to resources contribute to disparities in educational outcomes. While small sample studies highlight these inequities, population-level evidence is limited. OBJECTIVES: To quantify nationwide differences in school enrolment, attendance, and access to educational resourcing and support services between Autistic and non-Autistic children aged 5-12 years in Aotearoa New Zealand (NZ), and to examine variation by co-occurring intellectual disability (ID). METHODS: Cross-sectional analysis using NZ’s Integrated Data Infrastructure, including all children aged 5-12 in 2019. Autism and ID were identified from hospital, mental health, and disability service use datasets. Outcomes included enrolment, attendance, and access to supports. Propensity score matching (1:10) compared Autistic and non-Autistic students across outcomes, including stratification by ID status. RESULTS: Among 517,872 students aged 5-12 years, 8,169 (1.6%) were Autistic and of those 28.8% had co-occurring ID. Compared to matched peers, Autistic children were less likely to be enrolled in school (94.9% vs. 97.4%; Prevalence ratio [PR]=0.97, 95% confidence interval [CI]=0.97-0.98) but more likely to be enrolled in specialist schools (14.4% vs. 0.2%; PR=70.15, 95% CI=65.73-74.88), Te Kura (2.1% vs. 0.2%; PR=9.65, 95% CI=8.22-11.34), or home-schooling (2.2% vs. 0.9%; PR=2.45, 95% CI=2.11-2.84). Regular attendance was lower (49.3% vs. 61.2; PR=0.80, 95% CI=0.79-0.82), with higher rates of chronic absence (7.7% vs. 3.2%; PR=2.45, 95% CI=2.27-2.64). Access to supports was significantly higher for Autistic students across a range of services. Disparities were often more pronounced among Autistic children with ID. CONCLUSION: This study demonstrates significant differences in enrolment, attendance, and access to educational supports between Autistic and non-Autistic students in NZ, underscoring the urgent need for targeted and sufficiently resourced supports to ensure equitable participation.

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3. Butiu OR, Nechifor DA, Popescu T, Molnar RI, Mihai A. Stigmatization related experience among mothers of children with autism. Front Public Health;2026;14:1746420.

INTRODUCTIONS: This study investigates the relationship between stigmatization and stress levels among mothers of children with autism spectrum disorder (ASD). METHODS: Using items from standardized psychometric tools, the study explores how emotional burden, social strain, and coping strategies contribute to parents’ perceived stigma. RESULTS: Findings suggest that indirect measures of stigma through psychological assessment offer a more comprehensive understanding than direct questioning, which may elicit guarded responses.

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4. Cordina A, Todorov L, Guetta M, Pham-Scottez A, Ambar Akkaoui M. Management of patients with autism spectrum disorder in psychiatric emergency: a single-centre retrospective study. BMJ Open;2026 (Mar 24);16(3):e113611.

INTRODUCTION: Autism spectrum disorder (ASD) is one of the most prevalent neurodevelopmental disorders (NDDs) and is frequently associated with psychiatric and somatic comorbidities. As a result, individuals with ASD use emergency departments more frequently than the general population. However, the core features of ASD pose specific challenges in emergency department care, particularly for adult patients and emergency staff frequently report limited training in this area. While paediatric presentations of ASD in the emergency department are well documented, the international literature on adults remains limited. MATERIALS AND METHODS: we conducted a single-centre retrospective study including all patients aged 15 years and older with a diagnosis of ASD who attended the Centre Psychiatrique d’Orientation et d’Accueil (CPOA), GHU Paris (Groupe Hospitalo-Universitaire) between 12 January 2016 and 31 December 2023. The objectives were to estimate the prevalence of ASD in this psychiatric emergency setting and to describe the patients’ socio-demographic and clinical characteristics, mode of arrival, reasons for consultation and referral following the emergency visit. RESULTS: Among 69 447 patients who attended the CPOA during this period, 484 (0.7%) had a diagnosis of ASD. This population was predominantly male (71.9%), with a mean age of 25.1 years. The most frequent reasons for consultation were hetero-aggressive behaviour (37.0%) and anxiety (31.0%). Overall, 39.2% of patients were hospitalised, including 17.3% involuntarily, and 6.2% required physical restraint. The number of consultations involving patients with ASD increased significantly between 2016-2023. DISCUSSION AND CONCLUSION: This study provides a clearer understanding of the clinical and organisational challenges associated with the management of adult patients with ASD in psychiatric emergency departments. Although this study was descriptive and did not assess specific interventions, the observed patterns, in line with previous literature, suggest that adopted care strategies may help better address the needs of this population.

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5. Depoortère R, Tranfaglia MR, Newman-Tancredi A. The selective 5-HT(1A) receptor biased agonist, NLX-101, corrects anomalous behavioral phenotype in a mouse model of fragile X syndrome. Prog Neuropsychopharmacol Biol Psychiatry;2026 (Mar 22):111681.

Fragile X syndrome (FXS) is the most prevalent X-linked dominant autism spectrum disorder, causing a range of developmental problems, notably characterized by mild-severe mood/cognitive dysfunctions. NLX-101 is a highly selective and fully efficacious biased agonist at post-synaptic 5-HT(1A) receptors, and has shown efficacy for reversal of sensory hypersensitivity and EEG anomalies in transgenic mouse models of FXS. Presently, we examined the ability of NLX-101 to « normalize » (i.e., restore to levels observed in wild-type mice) several aspects of behavioral anomalies displayed by adult male FMR1 KO2 mice, a transgenic murine model of FXS. FMR1 KO2 mice were treated with NLX-101 (0.64 or 2.5 mg/kg intraperitoneally) and tested sequentially in 1) the open-field test to study hyperactivity and stereotypies (self-grooming), 2) the three chamber partition test (social memory), 3) the nesting behavior test (daily living), 4) the novel object recognition test (working memory) and 5) the hyponeophagia (novelty suppression feeding) test (anxiety). Each test was separated by a three-day wash-out period. NLX-101 normalized hyperactivity and excessive self-grooming at both 0.64 and 2.5 mg/kg, whereas hyponeophagia, and deficits in working and social memory, were partially (0.64 mg/kg) or fully (2.5 mg/kg) normalized. Abnormal nest building was partially normalized at 2.5 mg/kg. In conclusion, NLX-101 exerts beneficial and dose-dependent activity against several behavioral and mood/cognitive deficits displayed by FMR1 KO2 mice. These results highlight the therapeutic potential of using a selective post-synaptic 5-HT(1A) receptor biased agonist as a novel strategy to treat FXS, for which there is currently no approved efficacious and safe pharmacotherapy.

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6. Evenepoel M, Daniels N, Moerkerke M, Prinsen J, Steyaert J, Boets B, Joossens M, Alaerts K. The role of the oxytocinergic system in oral microbiome composition in children with autism: evidence from a randomized controlled trial of intranasal oxytocin. Transl Psychiatry;2026 (Mar 24)

Atypical oxytocinergic functioning and altered microbiome compositions have both been implicated in autism, with growing evidence of interactions between these systems. However, how exogenous oxytocin influences the oral microbiome remains largely unexplored. This exploratory study examined for the first time how oral microbiome alterations link to oxytocinergic signalling in school-aged autistic (n = 80) and non-autistic children (n = 40). Additionally, we investigated the effect of four-weeks of intranasal oxytocin administration in autistic children on oral microbiome compositions immediately post-treatment (T1) and at four-weeks follow-up (T2). At baseline, lower endogenous salivary oxytocin levels were linked to greater microbial evenness and diversity, with twelve genera showing significant associations with oxytocin levels. In autistic children, four weeks of oxytocin administration was associated with significant increases in the abundances of Centipeda immediately post-treatment (T0-T1), alongside decreases in Moraxella (T0-T1), and subsequent reductions in Rothia observed at the four-week follow-up (T1-T2). Particularly, the genus Moraxella emerged as relevant, as lower baseline abundance was associated with higher endogenous oxytocin levels, and a stronger oxytocin-induced downregulation of its abundance correlated with greater increases in endogenous oxytocin levels, accompanied by hypomethylation of the oxytocin receptor gene. All results persisted after adjusting for nutrition and dental care. This exploratory study provides initial evidence for a role of the oxytocinergic system in shaping the oral microbiome in autistic children. These results may facilitate the integration of oral microbiome profiling into autism diagnostic criteria and stimulate future studies on the use of oxytocin as a therapeutic option targeting oral microbiome alterations.

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7. Fadeev KA, Romero Reyes IV, Goiaeva DE, Ovsiannikova TM, Prokofyev AO, Rytikova AM, Novikov AY, Stroganova TA, Orekhova EV. Auditory P100m and Language Difficulties in Children With ASD: Effects of Vowel-Like Acoustic Structure. Autism Res;2026 (Mar 25):e70232.

The P100/P100m component of auditory event-related potentials/fields is considered a potential biomarker of atypical arousal and language difficulties in children with ASD. When elicited by complex speech-like sounds with regular temporal or frequency structure, P100/P100m may be influenced by sustained negativity (SN), which can reduce its amplitude due to opposing current polarity and contribute to ASD-related differences. Using magnetoencephalography (MEG), we examined P100m responses to acoustic regularities in the left and right auditory cortices in 35 ASD and 39 TD boys (7-12 years). Stimuli included (1) temporally and spectrally regular sounds (periodic vowels), (2) temporally regular sounds (periodic non-vowels), (3) spectrally regular sounds (non-periodic vowels), as well as (4) non-regular control stimuli (non-periodic, non-vowels). P100m was estimated using distributed source localization. Both groups showed decreased P100m amplitude and latency with acoustic regularities, accompanied by proportional SN increases, suggesting P100m modulation primarily reflects early SN enhancement. No group differences were observed in P100m latency or amplitude, and their modulation by stimulus type was also normal in ASD, indicating spared processing of acoustic regularities in the P100m time range. However, P100m latencies variability was increased in boys with ASD, and their left P100m amplitudes to both non-regular and regular sounds were negatively associated with cumulative language and intellectual abilities. These findings suggest that while most children with ASD show typical P100m responses, individual variations in P100m amplitude may reflect neurodevelopmental differences in cortical maturation and/or sensory habituation processes that contribute to the heterogeneity of cognitive and language abilities in ASD. Previous studies have linked the child auditory response to language abilities in ASD. In the present study, we examined how vowel‐like temporal and spectral regularities influence P100m and its association with language skills. Although group‐level P100m measures were within the typical range in children with ASD, higher P100m amplitude was associated with lower language scores and IQ, irrespective of the vowel‐like features of the stimuli. Given that P100m amplitude typically decreases with age and stimulus repetition, variability in its magnitude may reflect differences in the maturation of the auditory cortex or in habituation processes that are relevant for language and cognitive development in ASD. eng

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8. Immaculée D, Teshome GS, Kayiranga D, Uwimana P. Sexual and Reproductive Health Needs for Adolescents with Autistic Spectrum Disorder in Rwanda, A Phenomenological Study. Pediatric Health Med Ther;2026;17:572464.

BACKGROUND: Adolescents with autistic spectrum disorder have unique sexual and reproductive health needs that are often overlooked in health service planning and delivery. Despite their right to access accurate information and appropriate care, they face significant barriers. OBJECTIVE: This study aims to explore the sexual and reproductive health needs for adolescents with autistic spectrum disorder in Rwanda. METHODS: A phenomenological qualitative study was conducted in February 2025 at two centers in Gasabo District, Rwanda. Data were collected through focus group discussions from autistic spectrum disorder centers selected via purposive sampling. Data was saturated after conducting 3 FGDs. Transcripts were analyzed using NVivo and thematic analysis. RESULTS: This study revealed that adolescents with autistic spectrum disorder struggle with interpreting social cues and managing relationships, affecting their social and emotional development. A major barrier to accessing sexual and reproductive health services is the limited awareness among both adolescents and their families, along with a lack of information tailored to their specific needs. Challenges such as long travel distances, financial constraints, and cultural stigma rooted in misconceptions about their sexual and reproductive health needs further discourage families from seeking appropriate care due to fear of judgment and social rejection. CONCLUSION: The study found that adolescents with autistic spectrum disorder face challenges in understanding social cues and forming relationships, affecting their sexual and reproductive health experiences. Barriers include limited awareness among families about specialized SRH services, logistical difficulties, and lack of tailored information. Cultural stigma and misconceptions further prevent families from seeking appropriate care, highlighting the need for inclusive and accessible SRH support.

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9. Kaçar Kütükçü D, Karalı FS, Çınar N. Language and Repetition Performance in Autism Spectrum Disorder Versus Developmental Language Disorder: Evidence From Turkish-Speaking Children. Autism Res;2026 (Mar 25):e70236.

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by persistent differences in social communication and interaction, as well as restricted and repetitive patterns of behavior, interests, or activities. Language difficulties are common in autism and can affect multiple domains, including phonology, morphology, syntax, semantics, and pragmatics. This study examined the language and repetition skills of Turkish-speaking autistic children (diagnosed with ASD), children with developmental language disorder (DLD), and typically developing (TD) peers. Ninety children aged 5-9 years participated: 30 autistic children, 30 children with DLD, and 30 TD children. Language abilities were assessed using the Turkish School Age Language Development Test (TODİL), the LITMUS Turkish Sentence Repetition Test (LITMUS-TR), and the Turkish Nonword Repetition Test (TAST). The TD group scored significantly higher than both clinical groups across all measures. In direct comparisons between the clinical groups, autistic children had lower scores than children with DLD on several morphosyntactic and lexical-semantic measures. After Bonferroni correction, only morpheme completion (TODİL BT) differed significantly between the groups; associated vocabulary (TODİL IS) and word description (TODİL SB) showed smaller differences that did not reach the Bonferroni-adjusted significance threshold. The two clinical groups showed similar performance on picture vocabulary (TODİL RS), sentence comprehension (TODİL CA), sentence repetition (TODİL CT; LITMUS-TR), and nonword repetition (TAST). The findings indicate specific areas of relative difficulty in morphosyntactic and lexical-semantic processing among autistic children in this sample, alongside broadly similar performance to children with DLD on other sentence-level and repetition measures. These results suggest the potential value of tailored, evidence-based interventions that consider autistic children’s individual language profiles, while also taking into account broader cognitive and executive functioning needs. This research examines the language and repetition abilities of Turkish‐speaking children diagnosed with autism and DLD. The results underscore important differences in language processing and use across these groups. This research aims to clarify these distinctions in order to inform more effective language intervention programs for autistic children and children with DLD, with the goal of supporting improved communicative outcomes and quality of life. eng

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10. Kang J, Wu J, Li Y, Liu N, Li X, Chen H. Multidimensional reorganization of static and dynamic brain network architecture following rTMS in young children with autism spectrum disorder and co-occurring intellectual disability. Prog Neuropsychopharmacol Biol Psychiatry;2026 (Mar 22):111674.

AIMS: Repetitive transcranial magnetic stimulation (rTMS) has emerged as a promising intervention for autism spectrum disorder (ASD). However, the neurophysiological mechanisms driving its therapeutic effects, particularly regarding the complex reorganization of brain network dynamics, remain largely uncharacterized. This study aimed to elucidate the multidimensional network reconfiguration induced by low-frequency rTMS and identify specific electrophysiological predictors of clinical response in young children with ASD. METHODS: In a randomized, sham-controlled trial, 44 young children with ASD were assigned to receive either active (1 Hz, left dorsolateral prefrontal cortex) or sham rTMS for 20 sessions. Resting-state EEG data were acquired at baseline and post-intervention. We employed a comprehensive analytical framework integrating static Low- and High-Order Functional Connectivity (LOFC/HOFC), graph theoretical topology, dynamic Network State Entropy (NSE), and between-frequency coupling to assess network reconfiguration. Clinical efficacy was evaluated using the Autism Behavior Checklist (ABC). RESULTS: Active rTMS yielded significant improvements in sensory behavior and total behavioral scores compared to sham stimulation. Neurophysiologically, rTMS induced a « restorative » reorganization characterized by: (1) the suppression of pathological hyper-connectivity in the delta band and the enhancement of long-range synchronization in the alpha band; (2) the optimization of network topology, evidenced by increased global and local efficiency in the alpha band; (3) the modulation of dynamic flexibility, manifested as stabilized low-frequency dynamics and enhanced high-frequency metastability; and (4) the decoupling of aberrant cross-frequency interactions, specifically reducing pathological δ-β coupling. Crucially, the increase in delta network segregation and the reduction in pathological delta-beta coupling were significantly correlated with the magnitude of clinical symptom alleviation. CONCLUSIONS: Low frequency rTMS promotes a systemic reorganization of brain networks in children with ASD, shifting the neural architecture from a disorganized, hyper-connected state towards an optimized, hierarchically structured system. Despite the limited spatial resolution of portable EEG, the rigorous multidimensional analysis revealed robust temporal dynamic changes. The direct link between network segregation, cross-frequency decoupling, and sensory-behavioral gains highlights multidimensional EEG metrics as potential biomarkers for monitoring therapeutic responses in early ASD intervention.

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11. Martín-Díaz P, Carratalá-Tejada M, Navarro-López V, Fernández-González P, Cuesta-Gómez A. Static and dynamic balance in children and adolescents with autism spectrum disorder compared with typically developing peers: a systematic review and meta-analysis. Eur J Pediatr;2026 (Mar 24);185(4)

Children and adolescents with autism spectrum disorder (ASD) often present motor difficulties, particularly in postural control, which can affect their autonomy and participation in daily activities. Despite growing interest in balance assessment, there is no comprehensive synthesis comparing balance performance in ASD using both observational and instrumental methods. To compare the static and dynamic balance of children and adolescents with ASD versus typically developing (TD) peers, and to identify the tools most used to assess balance in this population. A systematic review and meta-analysis were conducted following PRISMA guidelines. Six electronic databases were searched to November 2025. Inclusion criteria focused on studies assessing static or dynamic balance in children aged 6-18 with ASD, using validated observational or instrumental tools, and including a TD group. Data extraction, methodological quality assessment, risk‑of‑bias evaluation, and GRADE assessment were performed independently by two reviewers, with discrepancies resolved by discussion or by a third reviewer. Standardized mean differences (SMDs) were calculated using random-effects models, established a priori to account for expected clinical heterogeneity. A total of 34 studies were included in the descriptive synthesis and 16 in the meta-analyses, encompassing 1278 participants (612 ASD, 666 TD). Observational tools (e.g., MABC-2, BOT-2) revealed significantly poorer balance in ASD participants ((SMD = -0.66; 95% CI: -1.07 to -0.25; p = 0.002). Force platform assessments demonstrated larger differences across postural sway measures: mediolateral displacement (stable surface: eyes open SMD = 0.83, eyes closed SMD = 0.56), anteroposterior displacement (stable surface: eyes open SMD = 0.97, eyes closed SMD = 0.27), COM displacement area (SMD = 1.15-7.72 depending on condition), and COM velocity (SMD = 1.00-3.23 depending on condition). Heterogeneity ranged from moderate to very high (I(2) = 0-98%). Sensitivity analyses indicated that some effect estimates, particularly for COM displacement area, were influenced by individual studies. The overall certainty of evidence was low to very low according to GRADE. CONCLUSION: Children with ASD may exhibit poorer static and dynamic balance compared to TD peers using both observational and instrumental assessments. Further high-quality studies are needed to strengthen the evidence base and enhance ecological validity in real-world settings. WHAT IS KNOWN: • Children and adolescents with autism spectrum disorder (ASD) frequently experience balance problems that affect daily functioning and participation. • Earlier reviews have described postural control in ASD but have not examined in depth the instruments used for its assessment. WHAT IS NEW: • This review provides a systematic overview of the clinical and biomechanical tools applied to evaluate balance in ASD. • It also compares the performance of children across different assessment methods, offering practical guidance for clinicians and educators when selecting appropriate measures.

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12. Qian W, Chen C, Wei B. Bullying, minority stress and revenge impulse among autistic college students: group differences by sexual and gender minority status. Front Public Health;2026;14:1727508.

This study examines how bullying experiences are associated with retaliatory impulses among autistic university students, highlighting minority stress as a key mediating mechanism and sexual and gender minority (SGM) status as a moderating condition within an intersectional framework. Guided by Minority Stress Theory and Social Information Processing Theory, we surveyed 280 autistic undergraduates; 35% identified as SGM. Participants completed validated measures of bullying, minority stress, retaliatory impulse, and related psychosocial factors. Structural equation modeling and multi-group analyses were conducted to evaluate the proposed mediation and moderation patterns while adjusting for gender, grade level, social support, autistic traits, and internet use. The measurement model showed good reliability and convergent validity (Cronbach’s α = 0.84-0.89; AVE = 0.62-0.69). Bullying was positively associated with minority stress, which was in turn associated with retaliatory impulses, supporting partial mediation [indirect effect = 0.42, 95% CI (0.36, 0.50)]. Multi-group results indicated stronger path coefficients in the SGM group (bullying → stress β = 0.72; stress → retaliation β = 0.66) than among non-SGM (heterosexual and cisgender) peers, consistent with the possibility that compounded stigma heightens emotional reactivity and defensive processing. Minority stress remained the strongest correlate of retaliatory impulses after covariate adjustment, whereas social support showed a protective association. Taken together, the findings suggest that retaliatory impulses among autistic students are better understood in relation to sustained identity-based exclusion and structural stressors rather than as simple dispositional aggression. The results also imply that effective prevention may require institutional and relational strategies-alongside individual support-such as inclusive curricula, peer sensitization, and policies that strengthen belonging and psychological safety in higher education.

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13. Weng TT, Gao GP, Jia XM, Wang QY, Yan SQ, Tong J, Tao FB. [Association of maternal prepregnancy overweight and gestational diabetes with autistic-like behaviors in children]. Zhonghua Liu Xing Bing Xue Za Zhi;2026 (Mar 10);47(3):495-500.

Objective: To investigate the association of prepregnancy overweight/obesity and gestational diabetes mellitus (GDM) with autistic-like behaviors in children. Methods: The data from the Ma’anshan Birth Cohort between May 2013 and September 2014 were used,the information about prepregnancy weight, height, gestational weight gain, and pregnancy complications were collected in the first, second, and third trimesters. Children were screened for autistic-like behaviors at 18 months of age. Logistic regression models were used to analyze the association of prepregnancy overweight/obesity and GDM with autistic-like behaviors in children. Multiplicative and additive interaction analyses were conducted to explore potential interactive effects of maternal prepregnancy overweight/obesity and GDM on autistic-like behaviors risk. Results: In the cohort, 401 cases (12.9%) of GDM and 309 cases (9.7%) of prepregnancy overweight were detected, respectively. A total of 432 cases (13.8%) children were screened to be positive for autism-like behaviors at 18 months of age. Logistic regression analysis revealed that both GDM and prepregnancy overweight/obesity showed significant positive associations with autistic-like behaviors in children (OR=1.41, 95%CI: 1.06-1.88; OR=1.43, 95%CI: 1.04-1.97). GDM complicated with prepregnancy overweight/obesity had a higher association with autistic-like behaviors in children (OR=2.42, 95%CI: 1.50-3.90), multiplicative interaction model analysis showed significant interactive effect between GDM and prepregnancy overweight/obesity on autistic-like behaviors risk in children (OR=2.29,95%CI:1.42-3.69). Conclusions: Prepregnancy overweight/obesity and GDM might increase the risk for social developmental disorders in children. Close attention should be paied to prepregnancy weight management and health monitoring for children exposed to these high-risk prenatal factors.

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14. Yildiz A, Topuz H, Önal H. Metabolic and mitochondrial alterations in children with autism spectrum disorder: The role of FGF-21 and GDF-15. Clin Chim Acta;2026 (Mar 22):120979.

INTRODUCTION: Autism Spectrum Disorder (ASD) is a neurodevelopmental condition marked by social communication deficits and repetitive behaviors. Evidence suggests that metabolic and mitochondrial stress contribute to ASD. Fibroblast growth factor 21 (FGF-21) and growth differentiation factor 15 (GDF-15) are circulating markers of mitochondrial dysfunction and cellular stress, but their role in pediatric ASD remains underexplored. METHODS: Case-control study involved 118 children: 88 with ASD (DSM-5 criteria) and 30 healthy controls matched by age and sex. ASD patients were divided by Autism Behavior Checklist (ABC) scores into Group I (ABC >60, n = 48) and Group II (ABC ≤60, n = 40). FGF-21 and GDF-15 were measured by ELISA. Biochemical parameters, hemogram, plasma amino acids (LC-MS/MS), and urinary organic acids (GC-MS) were analyzed. Statistical analyses included Kruskal-Wallis, Spearman correlation and ROC. RESULTS: FGF-21 was significantly elevated in ASD compared to controls (p < 0.0001), while GDF-15 showed no difference (p = 0.797). FGF-21 did not differ between Group I and Group II (p > 0.05). ASD showed increased lactate, lactate/pyruvate ratio, urea, AST, LDH, LDL, lymphocyte and platelet counts, and decreased pyruvate, serum and urinary creatinine (p < 0.05). Essential and branched-chain amino acids decreased, whereas glycine and histidine increased (p < 0.05). FGF-21 correlated weakly but significantly with mitochondrial dysfunction and amino acid metabolism markers. ROC showed good diagnostic accuracy for FGF-21 in ASD (AUC = 0.817), with 98.9% sensitivity and 73.3% specificity at 27.9 pg/mL cut-off. Urinary organic acids, methylmalonic acid, tiglylglycine, and 2-ketoisocaproic acid, were significantly elevated (p < 0.05). CONCLUSION: Elevated serum FGF-21 in children with ASD is linked to metabolic alterations, whereas GDF-15 remains unchanged. These results suggest FGF-21's association with metabolic dysregulation in ASD.

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