A quarterly publication of the Autism Research Institute

The Autism Research Review International is quarterly publication of the Autism Research Institute

Summer, 2019 | Number 3, Volume 33

High estrogen levels in utero may raise ASD risk

Exposure to high levels of estrogen before birth may increase the likelihood of autism spectrum disorder (ASD) in males, according to a new study. 

In earlier research, Simon Baron-Cohen and colleagues analyzed hormone levels in samples of amniotic fluid from 128 boys later diagnosed with ASD and 217 controls. The researchers found that samples from the boys who developed ASD contained elevated levels of testosterone as well as other hormones that are part of a pathway called the delta-4 sex steroid pathway. 

In a new study using amniotic fluid samples from a subgroup of the same children, the researchers analyzed levels of four forms of estrogen—estriol, estradiol, estrone, and estrone sulphate. The researchers found that all four forms of estrogen were significantly elevated in the 98 children who later developed autism, compared to the 177 who did not. In fact, the researchers found that high levels of prenatal estrogens were even more predictive of autism than high levels of prenatal androgens such as testosterone. 

The researchers note that in both males and females, prenatal estrogen plays a key role in the development of the cerebral cortex and the formation of synapses between neurons in the nervous system. Baron-Cohen comments, “This new finding supports the idea that increased prenatal sex steroid hormones are one of the potential causes for [ASD]. Genetics is well established as another, and these hormones likely interact with genetic factors to affect the developing fetal brain.”


“Foetal oestrogens and autism,” Simon BaronCohen, Alexandros Tsompanidis, Bonnie Auyeung, Bent Nørgaard-Pedersen, David M. Hougaard, Morsi Abdallah, Arieh Cohen, and Alexa Pohl, Molecular Psychiatry, July 29, 2019 (online). Address: Simon Baron-Cohen, [email protected]


“High levels of estrogen in the womb linked to autism,” news release, University of Cambridge, July 29, 2019.