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Discover Pediatric Collections on COVID-19 and Racism and Its Effects on Pediatric Health

American Academy of Pediatrics
Article

Maternal Metabolic Conditions and Risk for Autism and Other Neurodevelopmental Disorders

Paula Krakowiak, Cheryl K. Walker, Andrew A. Bremer, Alice S. Baker, Sally Ozonoff, Robin L. Hansen and Irva Hertz-Picciotto
Pediatrics May 2012, 129 (5) e1121-e1128; DOI: https://doi.org/10.1542/peds.2011-2583
Paula Krakowiak
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Cheryl K. Walker
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Andrew A. Bremer
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Alice S. Baker
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Sally Ozonoff
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Robin L. Hansen
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Irva Hertz-Picciotto
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Abstract

OBJECTIVE: We examined whether metabolic conditions (MCs) during pregnancy (diabetes, hypertension, and obesity) are associated with autism spectrum disorder (ASD), developmental delays (DD), or impairments in specific domains of development in the offspring.

METHODS: Children aged 2 to 5 years (517 ASD, 172 DD, and 315 controls) were enrolled in the CHARGE (Childhood Autism Risks from Genetics and the Environment) study, a population-based, case-control investigation between January 2003 and June 2010. Eligible children were born in California, had parents who spoke English or Spanish, and were living with a biological parent in selected regions of California. Children’s diagnoses were confirmed by using standardized assessments. Information regarding maternal conditions was ascertained from medical records or structured interview with the mother.

RESULTS: All MCs were more prevalent among case mothers compared with controls. Collectively, these conditions were associated with a higher likelihood of ASD and DD relative to controls (odds ratio: 1.61 [95% confidence interval: 1.10–2.37; odds ratio: 2.35 [95% confidence interval: 1.43–3.88], respectively). Among ASD cases, children of women with diabetes had Mullen Scales of Early Learning (MSEL) expressive language scores 0.4 SD lower than children of mothers without MCs (P < .01). Among children without ASD, those exposed to any MC scored lower on all MSEL and Vineland Adaptive Behavior Scales (VABS) subscales and composites by at least 0.4 SD (P < .01 for each subscale/composite).

CONCLUSIONS: Maternal MCs may be broadly associated with neurodevelopmental problems in children. With obesity rising steadily, these results appear to raise serious public health concerns.

KEY WORDS
  • autism
  • developmental delay
  • diabetes
  • epidemiology
  • hypertension
  • obesity
  • Abbreviations:
    ADI-R —
    Autism Diagnostic Interview, Revised
    ADOS —
    Autism Diagnostic Observation Schedule
    ASD —
    autism spectrum disorder
    CI —
    confidence interval
    DD —
    developmental delays
    EEQ —
    Environmental Exposure Questionnaire
    GDM —
    gestational diabetes
    GP —
    general population
    LS —
    least squares
    MC —
    metabolic condition
    MSEL —
    Mullen Scales of Early Learning
    OR —
    odds ratio
    T2D —
    type 2 diabetes
    TD —
    typical development
    VABS —
    Vineland Adaptive Behavior Scales
    • Accepted December 19, 2011.
    • Copyright © 2012 by the American Academy of Pediatrics

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    Pediatrics
    Vol. 129, Issue 5
    1 May 2012
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    Maternal Metabolic Conditions and Risk for Autism and Other Neurodevelopmental Disorders
    Paula Krakowiak, Cheryl K. Walker, Andrew A. Bremer, Alice S. Baker, Sally Ozonoff, Robin L. Hansen, Irva Hertz-Picciotto
    Pediatrics May 2012, 129 (5) e1121-e1128; DOI: 10.1542/peds.2011-2583

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    Maternal Metabolic Conditions and Risk for Autism and Other Neurodevelopmental Disorders
    Paula Krakowiak, Cheryl K. Walker, Andrew A. Bremer, Alice S. Baker, Sally Ozonoff, Robin L. Hansen, Irva Hertz-Picciotto
    Pediatrics May 2012, 129 (5) e1121-e1128; DOI: 10.1542/peds.2011-2583
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