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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Familial confounding of the association between maternal smoking in pregnancy and autism spectrum disorder in offspring
Autism research, v 13(1), pp 134-144
Jan 2020
PMID: 31464107
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Evidence supports no link between maternal smoking in pregnancy and autism spectrum disorder (autism) overall. To address remaining questions about the unexplained heterogeneity between study results and the possibility of risk for specific autism sub‐phenotypes, we conducted a whole‐population cohort study in Denmark. We followed births 1991–2011 (1,294,906 persons, including 993,301 siblings in 728,271 families), from 1 year of age until an autism diagnosis (13,547), death, emigration, or December 31, 2012. Autism, with and without attention deficit hyperactivity disorder (ADHD) and with and without intellectual disability (ID) were based on ICD‐8 and ICD‐10 codes from Danish national health registers, including 3,319 autism + ADHD, 10,228 autism − no ADHD, 2,205 autism + ID, and 11,342 autism − no ID. We estimated hazard ratios (HRs) and 95% confidence intervals (95% CIs) between any maternal smoking (from birth records) and autism (or sub‐phenotypes) using survival models with robust standard errors, stratifying by birth year and adjusting for child sex, parity, and parental age, education, income, and psychiatric history. To additionally address confounding using family designs, we constructed a maternal cluster model (adjusting for the smoking proportion within the family), and a stratified sibling model. Associations with maternal smoking and autism were elevated in conventional adjusted analyses (HR of 1.17 [1.13–1.22]) but attenuated in the maternal cluster (0.98 [0.88–1.09]) and sibling (0.86 [0.64–1.15]) models. Similarly, risks of autism sub‐phenotypes with maternal smoking were attenuated in the family‐based models. Together these results support that smoking in pregnancy is not linked with autism or select autism comorbid sub‐phenotypes after accounting for familial confounding. Autism Res 2020, 13: 134–144 . © 2019 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary Smoking during pregnancy has many harmful impacts, which may include harming the baby's developing brain. However, in a study of thousands of families in Denmark, it does not appear that smoking in pregnancy leads to autism or autism in combination with intellectual problems or attention deficits, once you account for the way smoking patterns and developmental disabilities run in families.
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Details
- Title
- Familial confounding of the association between maternal smoking in pregnancy and autism spectrum disorder in offspring
- Creators
- Amy E. Kalkbrenner - University of Wisconsin–MilwaukeeSandra M. Meier - Mental Health ServicesPaul Madley-Dowd - University of BristolChristine Ladd-Acosta - Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore Maryland, Wendy Klag Center for Autism and Developmental Disabilities Johns Hopkins Bloomberg School of Public Health Baltimore MarylandMargaret Daniele Fallin - Bloomberg (United States)Erik Parner - Aarhus UniversityDiana Schendel - Lundbeck Foundation
- Publication Details
- Autism research, v 13(1), pp 134-144
- Publisher
- Wiley
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- A.J. Drexel Autism Institute
- Web of Science ID
- WOS:000484582700001
- Scopus ID
- 2-s2.0-85071572976
- Other Identifier
- 991021463574904721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Behavioral Sciences
- Psychology, Developmental