The University of North Carolina, Chapel Hill, North Carolina.
California Department of Public Health, Richmond, California.
Autism Res. 2019 Jun;12(6):967-975. doi: 10.1002/aur.2105. Epub 2019 Apr 10.
Previous studies have shown complications of pregnancy, often examined in aggregate, to be associated with autism spectrum disorder (ASD). Results for specific complications, such as maternal diabetes and hypertension, have not been uniformly consistent and should be investigated independently in relation to ASD in a large community-based sample. The Study to Explore Early Development (SEED), a US multisite case-control study, enrolled children born in 2003-2006 at 2-5 years of age. Children were classified into three groups based on confirmation of ASD (n = 698), non-ASD developmental delay (DD; n = 887), or controls drawn from the general population (POP; n = 979). Diagnoses of any diabetes or hypertensive disorder during pregnancy were identified from prenatal medical records and maternal self-report. Logistic regression models estimated adjusted odds ratios (aOR) and confidence intervals (CI) adjusting for maternal age, race/ethnicity, education, smoking during pregnancy, and study site. Models for hypertension were additionally adjusted for parity and plurality. Among 2,564 mothers, we identified 246 (9.6%) with any diabetes and 386 (15.1%) with any hypertension in pregnancy. After adjustment for covariates, any diabetes during pregnancy was not associated with ASD (aOR = 1.10 [95% CI 0.77, 1.56]), but any hypertension was associated with ASD (aOR = 1.69 [95% CI 1.26, 2.26]). Results were similar for DD, and any diabetes (aOR = 1.29 [95% CI 0.94, 1.78]) or any hypertension (aOR = 1.71 [95% CI 1.30, 2.25]). Some pregnancy complications, such as hypertension, may play a role in autism etiology and can possibly serve as a prompt for more vigilant ASD screening efforts. Autism Res 2019, 12: 967-975. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: We studied if common complications in pregnancy are associated with autism spectrum disorder (ASD) in a large sample of mothers and children. Our results show an association between conditions marked by high blood pressure and ASD, but no association with conditions marked by high blood sugar and ASD. Associations were similar for children who had a developmental disorder that was not ASD, suggesting that this relationship may not be specific to ASD.
先前的研究表明，妊娠并发症通常作为一个整体进行研究，与自闭症谱系障碍（ASD）有关。但特定并发症（如母体糖尿病和高血压）的结果并不一致，因此应在大型基于社区的样本中独立研究这些并发症与 ASD 的关系。美国多地点病例对照研究“探索早期发育研究”（SEED）招募了 2003 年至 2006 年出生的儿童，在 2 至 5 岁时入组。根据 ASD（n=698）、非 ASD 发育迟缓（DD；n=887）或一般人群对照（POP；n=979）的确诊情况，将儿童分为三组。从产前病历和母亲自我报告中确定了妊娠期间任何糖尿病或高血压疾病的诊断。Logistic 回归模型估计了调整后的比值比（aOR）和置信区间（CI），并调整了母亲年龄、种族/民族、教育程度、妊娠期间吸烟和研究地点。高血压模型还调整了产次和多胎次。在 2564 位母亲中，我们发现 246 位（9.6%）患有任何类型的糖尿病，386 位（15.1%）患有任何妊娠高血压。在调整了混杂因素后，妊娠期间任何糖尿病与 ASD 无关（aOR=1.10 [95%CI 0.77, 1.56]），但任何高血压均与 ASD 相关（aOR=1.69 [95%CI 1.26, 2.26]）。对于 DD 和任何糖尿病（aOR=1.29 [95%CI 0.94, 1.78]）或任何高血压（aOR=1.71 [95%CI 1.30, 2.25]），结果也类似。一些妊娠并发症，如高血压，可能在自闭症发病机制中发挥作用，并且可能为更严格的 ASD 筛查工作提供依据。自闭症研究 2019，12：967-975。©2019 自闭症国际研究协会，Wiley 期刊，公司。
