Journal article
Cross-Setting Replication of the Associations Between Maternal Health and Autism
Journal of the American Academy of Child and Adolescent Psychiatry
21 Nov 2025
PMID: 41275908
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental condition with early-life origins. Maternal health conditions during pregnancy have been linked to autism risk, but most studies have focused on single populations, thus limiting generalizability. We examined whether associations previously reported in a Danish registry–based study were similar in a US cohort.
We analyzed electronic health records of children born between 2010 and 2017 at Kaiser Permanente Northern California (KPNC), along with their mothers. Maternal diagnoses were classified as chronic or non-chronic. Associations with ASD in the child were assessed using Cox models, adjusting for sociodemographic factors, health care use, and comorbid maternal diagnoses. Methods were aligned with the Danish study for comparability.
Among 224,353 children in the KPNC cohort, 5,448 (2.4%) were diagnosed with autism. Of the 42 maternal diagnoses significantly associated with autism in Denmark, 38 were evaluable in KPNC, and 18 remained statistically significant after adjustment. Most associations had point estimates consistent with the Danish study, particularly psychiatric and cardiometabolic conditions.
Despite demographic and health care differences, 35 of the 38 associations found in the Danish study replicated qualitatively (direction of effect) in the US cohort, suggesting robust cross-setting relevance. Further research is needed to explore underlying mechanisms and effect modifiers.
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Details
- Title
- Cross-Setting Replication of the Associations Between Maternal Health and Autism
- Creators
- Vahe Khachadourian - Icahn School of Medicine at Mount SinaiMeredith Anderson - Kaiser PermanenteElias Speleman Arildskov - Aarhus UniversityJakob Grove - Aarhus UniversityAbraham Reichenberg - Icahn School of Medicine at Mount SinaiSven Sandin - Karolinska InstitutetDiana Schendel - Drexel University, A.J. Drexel Autism InstituteStefan Nygaard Hansen - Aarhus UniversityLisa A. Croen - Kaiser PermanenteMagdalena Janecka - Icahn School of Medicine at Mount Sinai
- Publication Details
- Journal of the American Academy of Child and Adolescent Psychiatry
- Publisher
- Elsevier Inc
- Grant note
- National Institute of Mental Health Lundbeck Foundation
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- A.J. Drexel Autism Institute
- Scopus ID
- 2-s2.0-105028798020
- Other Identifier
- 991022133487804721