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Maternal health around pregnancy and autism risk: a diagnosis-wide, population-based study
Journal article   Open access   Peer reviewed

Maternal health around pregnancy and autism risk: a diagnosis-wide, population-based study

Arad Kodesh, Stephen Z. Levine, Vahe Khachadourian, Rayees Rahman, Avner Schlessinger, Paul F. O'Reilly, Jakob Grove, Diana Schendel, Joseph D. Buxbaum, Lisa Croen, …
Psychological medicine, v 52(16), pp 4076-4084
01 Dec 2022
DOI: https://doi.org/10.1017/S0033291721001021
PMID: 33766168
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://europepmc.org/articles/pmc8464612View
Accepted (AM)Open Access (License Unspecified),  Open
url
https://doi.org/10.1017/S0033291721001021View
Published, Version of Record (VoR) Open

Abstract

Life Sciences & Biomedicine Psychiatry Psychology Psychology, Clinical Science & Technology Social Sciences
Background Many studies have reported an increased risk of autism spectrum disorder (ASD) associated with some maternal diagnoses in pregnancy. However, such associations have not been studied systematically, accounting for comorbidity between maternal disorders. Therefore our aim was to comprehensively test the associations between maternal diagnoses around pregnancy and ASD risk in offspring. Methods This exploratory case-cohort study included children born in Israel from 1997 to 2008, and followed up until 2015. We used information on all ICD-9 codes received by their mothers during pregnancy and the preceding year. ASD risk associated with each of those conditions was calculated using Cox proportional hazards regression, adjusted for the confounders (birth year, maternal age, socioeconomic status and number of ICD-9 diagnoses during the exposure period). Results The analytic sample consisted of 80 187 individuals (1132 cases, 79 055 controls), with 822 unique ICD-9 codes recorded in their mothers. After extensive quality control, 22 maternal diagnoses were nominally significantly associated with offspring ASD, with 16 of those surviving subsequent filtering steps (permutation testing, multiple testing correction, multiple regression). Among those, we recorded an increased risk of ASD associated with metabolic [e.g. hypertension; HR = 2.74 (1.92-3.90), p = 2.43 x 10(-8)], genitourinary [e.g. non-inflammatory disorders of cervix; HR = 1.88 (1.38-2.57), p = 7.06 x 10(-5)] and psychiatric [depressive disorder; HR = 2.11 (1.32-3.35), p = 1.70 x 10(-3)] diagnoses. Meanwhile, mothers of children with ASD were less likely to attend prenatal care appointment [HR = 0.62 (0.54-0.71), p = 1.80 x 10(-11)]. Conclusions Sixteen maternal diagnoses were associated with ASD in the offspring, after rigorous filtering of potential false-positive associations. Replication in other cohorts and further research to understand the mechanisms underlying the observed associations with ASD are warranted.

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12 citations in Web of Science
13 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Psychiatry
Psychology
Psychology, Clinical
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