Maternal Health and Autism Risk

Janelle Blankenship, PharmD

July 07, 2022

The study covered in this summary was published on MedRxiv.org as a preprint and has not yet been peer reviewed.

Key Takeaways

  • Various chronic and nonchronic maternal diagnoses around pregnancy were significantly associated with risk for autism spectrum disorder (ASD) in offspring.

  • An increased risk for ASD was found in children whose mothers had been diagnosed with certain mental health conditions, digestive system disorders, epilepsy, gestational diabetes, and injuries unrelated to pregnancy.

Why This Matters

  • This study highlights the relationship between maternal health around the time of pregnancy and ASD risk in offspring.

  • The research confirms some previously established associations between maternal diagnoses and ASD and identifies several new associations.

  • Further research is needed to examine the etiology of ASD and determine how these conditions affect fetal neurodevelopment.

Study Design

  • This population-based cohort study used the Danish Central Population Register to identify all children born in Denmark between 1998 and 2007 (N = 653,580) and their mothers (N = 425,399).

  • The Danish Psychiatric Central Research Register and Danish National Patient Register were used to obtain information on chronic and nonchronic maternal diagnoses and ASD diagnoses in offspring.

  • Maternal diagnoses were based on ICD-10 level 3 diagnostic codes, and conditions that were found in fewer than 20 mothers were excluded from the analysis.

  • The detection period for maternal diagnoses included the 48 months preceding childbirth for chronic conditions and the 24 months preceding childbirth for nonchronic conditions.

Key Results

  • During the follow-up period, 7866 children (1.2%) were diagnosed with ASD. The median age at first ASD diagnosis was 6.8 years (interquartile range, 4.8-9.4 years).

  • There were no significant differences in maternal age at delivery or total number of maternal diagnoses in the 24 months before childbirth for children with ASD vs children without ASD.

  • In the multivariable model, chronic maternal conditions that showed a significant association with ASD included recurrent major depressive disorder (hazard ratio [HR], 1.89; 95% CI, 1.39-2.56), dentofacial anomalies (HR, 1.62; 95% CI, 1.12-2.35), epilepsy and recurrent seizures (HR, 1.49; 95% CI, 1.17-1.89), irritable bowel syndrome (HR, 1.41; 95% CI, 1.05-1.89), and reaction to severe stress and adjustment disorders (HR, 1.21; 95% CI, 1.01-1.45). Conversely, a significant negative association was found for diagnosis of ASD in children born to nonsmoking mothers (HR, 0.79; 95% CI, 0.74-0.85).

  • Nonchronic maternal conditions associated with increased risk for ASD included noninfective gastroenteritis and colitis (HR, 1.67; 95% CI, 1.08-2.57), fracture of skull and facial bones (HR, 1.61; 95% CI, 1.09-2.37), injury of unspecified body region (HR, 1.54; 95% CI, 1.19-1.98), muscle disorders (HR, 1.29; 95% CI, 1.05-1.59), gestational diabetes (HR, 1.28; 95% CI, 1.08-1.51), and superficial hand or wrist injury (HR, 1.21; 95% CI, 1.03-1.43).

Limitations

  • The investigators did not consider maternal medication use and could not assess the impact of medication on risk for ASD in offspring.

  • They did not have information on education, ethnicity, immigration status, or household income and could not control for the effect of these sociodemographic factors on risk for ASD.

  • At least one recording of a specific diagnostic code was required to include a maternal diagnosis. Though this approach was used to increase sensitivity, it may have led to decreased specificity.

Disclosures

  • This work was supported by the Seaver Foundation and a grant from the National Institute of Mental Health.

  • The authors declared no competing interests.

This is a summary of a preprint research study, "Maternal Diagnoses Around Pregnancy and Risk of Autism Spectrum Disorder - A Population-Based Study ," written by Vahe Khachadourian from Icahn School of Medicine at Mount Sinai and colleagues, on MedRxiv.org and provided to you by Medscape. This study has not yet been peer reviewed. The full text of the study can be found on MedRxiv.org.

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