Journal article
Familial confounding in the associations between maternal health and autism
Nature medicine
31 Jan 2025
PMID: 39891002
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Evidence suggests that maternal health in pregnancy is associated with autism in the offspring. However, most diagnoses in pregnant women have not been examined, and the role of familial confounding remains unknown. Our cohort included all children born in Denmark between 1998 and 2015 (n = 1,131,899) and their parents. We fitted Cox proportional hazard regression models to estimate the likelihood of autism associated with each maternal prenatal ICD-10 diagnosis, accounting for disease chronicity and comorbidity, familial correlations and sociodemographic factors. We examined the evidence for familial confounding using discordant sibling and paternal negative control designs. Among the 1,131,899 individuals in our sample, 18,374 (1.6%) were diagnosed with autism by the end of follow-up. Across 236 maternal diagnoses we tested (prevalence ≥0.1%), 30 were significantly associated with autism after accounting for sociodemographic factors, disorder chronicity and comorbidity, and correction for multiple testing. This included obstetric, cardiometabolic and psychiatric disorders (for example, diabetes in pregnancy (hazard ratio (HR) 1.19, 95% confidence interval (CI) 1.08-1.31) and depression (HR 1.49, 95% CI 1.27-1.75)), previously shown to be associated with autism. Family-based analyses provided strong evidence for familial confounding in most of the observed associations. Our findings indicate pervasive associations between maternal health in pregnancy and offspring autism and underscore that these associations are largely attributable to familial confounding.
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Details
- Title
- Familial confounding in the associations between maternal health and autism
- Creators
- Vahe Khachadourian - New York UniversityElias Speleman Arildskov - Aarhus UniversityJakob Grove - Aarhus UniversityPaul F O'Reilly - Icahn School of Medicine at Mount SinaiJoseph D Buxbaum - Icahn School of Medicine at Mount SinaiAbraham Reichenberg - Icahn School of Medicine at Mount SinaiSven Sandin - Icahn School of Medicine at Mount SinaiLisa A Croen - Kaiser PermanenteDiana Schendel - Lundbeck FoundationStefan Nygaard Hansen - Aarhus UniversityMagdalena Janecka - New York University
- Publication Details
- Nature medicine
- Publisher
- NATURE PORTFOLIO; BERLIN
- Number of pages
- 23
- Grant note
- HD098883 / U.S. Department of Health & Human Services | NIH | Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) R102-A9118 / Lundbeckfonden (Lundbeck Foundation) MH124817 / U.S. Department of Health & Human Services | NIH | National Institute of Mental Health (NIMH) T32-MH122394 / U.S. Department of Health & Human Services | NIH | National Institute of Mental Health (NIMH) R155- 2014-1724 / Lundbeckfonden (Lundbeck Foundation)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- A.J. Drexel Autism Institute
- Web of Science ID
- WOS:001410259400001
- Scopus ID
- 2-s2.0-85217257537
- Other Identifier
- 991022026419004721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Biochemistry & Molecular Biology
- Cell Biology
- Medicine, Research & Experimental