Journal article
Associations between Prenatal Perceived Stress and Child Autism-Related Traits in the ECHO Cohort
The Journal of pediatrics, v 293, p115054
02 Mar 2026
PMID: 41780671
Abstract
To examine associations of prenatal perceived stress with child autism-related traits and to evaluate effect modification by both child sex and co-occurring prenatal depressive symptoms.
The sample was drawn from Environmental Influences on Child Health Outcomes (ECHO) Cohort sites with data on prenatal perceived stress (Perceived Stress Scale [PSS]) and autism-related traits (Social Responsiveness Scale, 2nd Edition [SRS-2]). We used linear and logistic regression models to determine associations between PSS and either SRS-2 T-scores or odds of moderate-to-severe autism-related traits (SRS-2 T-score ≥65) and evaluated effect modification by sex and prenatal depressive symptoms (PDEP).
Among 4,115 mother–child pairs, higher PSS was associated with increased severity of autism-related traits (β=0.15 [95% CI=0.13-0.18]) and odds of moderate-to-severe traits (OR=1.04 [1.04–1.05]). There was evidence for sex-by-exposure interaction for continuous (βMales=0.18 [0.14–0.22]; βFemales=0.13 [0.10–0.16], Pinteraction=0.03) but not dichotomous trait severity (ORMales=1.05 [1.03–1.06]; ORFemales=1.04 [1.03–1.05], Pinteraction=0.52). Associations did not differ by PDEP (Low: N=2,538, b=0.14 [0.11–0.18]; High: N=889, b=0.10 [0.04–0.15]; Pinteraction=0.66).
We found small yet significant associations between prenatal stress and autism-related traits. Limited evidence for effect modification by sex or prenatal depressive symptoms suggests prenatal perceived stress influences autism-related traits after accounting for these factors.
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Details
- Title
- Associations between Prenatal Perceived Stress and Child Autism-Related Traits in the ECHO Cohort
- Creators
- Luke P. Grosvenor - Kaiser PermanenteMonica McGrath - Johns Hopkins UniversityJasmine Douglas - Johns Hopkins UniversityJennifer L. Ames - Kaiser PermanenteNdidiamaka Amutah-Onukagha - Tufts UniversityLyndsay Avalos - Kaiser PermanenteBrennan H. Baker - Seattle Children's HospitalPatricia A. Brennan - Emory UniversityNeika Christalin - Tufts UniversityAssiamira Ferrara - Kaiser PermanenteKendria Kelly-Taylor - Kaiser PermanenteKristen Lyall - Drexel UniversityRuby H.N. Nguyen - University of MinnesotaRebecca J. Schmidt - University of California, DavisLisa A. Croen - Kaiser PermanenteECHO Cohort Consortium
- Publication Details
- The Journal of pediatrics, v 293, p115054
- Publisher
- Elsevier Inc; NEW YORK
- Number of pages
- 10
- Grant note
- (Hertz-Picciotto): UG3/UH3OD023244, UG3/UH3OD023275, UH3OD023271, UG3OD035528, UH3OD023347, UG3/UH3OD023389, UG3/UH3OD023344, UH3OD023268, UG3/UH3OD023288, UG3/UH3OD023342, UG3/UH3OD023349, UH3OD023286, UG3OD035533, UG3/UH3OD023348, UG3/UH3OD023285, UG3/UH3OD023290, UG3/UH3OD023272, UG3/UH3OD023249, UG3/UH3OD023305, UG3/UH3OD023337, UG3OD035508, UG3OD035509, UG3OD035513, UG3OD035532, UG3OD035516, UG3OD035517, UG3OD035518, UG3OD035519, UG3OD035521, UG3OD035527, UG3OD035540, UG3OD035543, UG3OD035537, UG3OD035529, UG3OD035542, UG3OD035550, UG3OD035536, UG3OD035544 NIH ECHO Data Analysis Center
Hertz-Picciotto) , UG3/UH3OD023244 (Alison Hipwell) , UG3/UH3OD023275 (Margaret Karagas) , UH3OD023271 and UG3OD035528 (Catherine Karr) , UH3OD023347 (Barry Lester) , UG3/UH3OD023389 (Leslie Leve) , UG3/UH3OD023344 (Debra MacKenzie) , UH3OD023268 (Scott Weiss) , UG3/UH3OD023288 (Cynthia McEvoy) , UG3/UH3OD023342 (Kristen Lyall) , UG3/UH3OD023349 (Thomas O'Connor) , UH3OD023286 and UG3OD035533 (Emily Oken) , UG3/UH3OD023348 (Mike O'Shea) , UG3/UH3OD023285 (Jean Kerver) , UG3/UH3OD023290 (Julie Herbstman) , UG3/UH3OD023272 (Susan Schantz) , UG3/UH3OD023249 (Joseph Stanford) , UG3/UH3OD023305 (Leonardo Trasande) , UG3/UH3OD023337 (Rosalind Wright) , UG3OD035508 (Sheela Sathyanarayana) , UG3OD035509 (Anne Marie Singh) , UG3OD035513 and UG3OD035532 (Annemarie Stroustrup) , UG3OD035516 and UG3OD035517 (Tina Hartert) , UG3OD035518 (Jennifer Straughen) , UG3OD035519 (Qi Zhao) , UG3OD035521 (Katherine Rivera-Spoljaric) , UG3OD035527 (Emily S Barrett) , UG3OD035540 (Monique Marie Hedderson) , UG3OD035543 (Kelly J Hunt) , UG3OD035537 (Sunni L Mumford) , UG3OD035529 (Hong-Ngoc Nguyen) , UG3OD035542 (Hudson Santos) , UG3OD035550 (Rebecca Schmidt) , UG3OD035536 (Jonathan Slaughter) , UG3OD035544 (Kristina Whitworth) . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The sponsor, NIH, participated in the overall design and implementation of the ECHO Program, which was funded as a cooperative agreement between NIH and grant awardees. The sponsor approved the Steering Committee-developed ECHO protocol and its amendments including COVID-19 measures. The sponsor had no access to the central database, which was housed at the ECHO Data Analysis Center. Data management and site monitoring were performed by the ECHO Data Analysis Center and Coordinating Center. All analyses for scientific publication were performed by the study statistician, independently of the sponsor. The lead author wrote all drafts of the manuscript and made revisions based on co-authors and the ECHO Publication Committee (a subcommittee of the ECHO Operations Committee) feedback without input from the sponsor. The study sponsor did not review or approve the manuscript for submission to the journal. The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:001734509700001
- Other Identifier
- 991022166475804721