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Abstract
General & Internal Medicine Life Sciences & Biomedicine Medicine, General & Internal Science & Technology
Objective To determine whether nutritional supplementation during pregnancy is associated with a reduced risk of autism spectrum disorder (ASD) with and without intellectual disability in offspring.
Design Observational prospective cohort study using multivariable logistic regression, sibling controls, and propensity score matching.
Setting Stockholm County, Sweden.
Participants 273 107 mother-child pairs identified through population registers. The study sample was restricted to children who were aged 4 to 15 years by the end of follow-up on 31 December 2011 and were born between 1996 and 2007.
Exposures Multivitamin, iron, and folic acid supplement use was reported at the first antenatal visit.
Main outcome measure Diagnosis of ASD with and without intellectual disability in children determined from register data up to 31 December 2011.
Results Prevalence of ASD with intellectual disability was 0.26% (158 cases in 61 934) in the maternal multivitamin use group and 0.48% (430 cases in 90 480) in the no nutritional supplementation use group. Maternal multivitamin use with or without additional iron or folic acid, or both was associated with lower odds of ASD with intellectual disability in the child compared with mothers who did not use multivitamins, iron, and folic acid (odds ratio 0.69, 95% confidence interval 0.57 to 0.84). Similar estimates were found in propensity score matched (0.68, 0.54 to 0.86) and sibling control (0.77, 0.52 to 1.15) matched analyses, though the confidence interval for the latter association included 1.0 and was therefore not statistically significant. There was no consistent evidence that either iron or folic acid use were inversely associated with ASD prevalence.
Conclusions Maternal multivitamin supplementation during pregnancy may be inversely associated with ASD with intellectual disability in offspring. Further scrutiny of maternal nutrition and its role in the cause of autism is recommended.
Antenatal nutritional supplementation and autism spectrum disorders in the Stockholm youth cohort: population based cohort study
Creators
Elizabeth A. DeVilbiss - Drexel University
Cecilia Magnusson - Stockholm Centre of Public Health
Renee M. Gardner - Stockholm Centre of Public Health
Dheeraj Rai - University of Bristol
Craig J. Newschaffer - Drexel University
Kristen Lyall - Center for Autism and Related Disorders
Christina Dalman - Stockholm Centre of Public Health
Brian K. Lee - Drexel University
Publication Details
BMJ (Online), v 359, pp j4273-j4273
Publisher
Bmj Publishing Group
Number of pages
10
Grant note
Swedish Research Council; European Commission
1 R21 ES023760-01A1 / National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA
R21ES023760 / NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Environmental Health Sciences (NIEHS)
National Institute for Health Research Biomedical Research Centre Bristol
Resource Type
Journal article
Language
English
Academic Unit
Epidemiology and Biostatistics; A.J. Drexel Autism Institute
Web of Science ID
WOS:000412826200005
Scopus ID
2-s2.0-85030653062
Other Identifier
991019169657104721
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