Maternal Metabolic Conditions and Risk for Autism and Other Neurodevelopmental Disorders

Overview

Journal Pediatrics

Specialty Pediatrics

Date 2012 Apr 12

PMID 22492772

Citations 300

Authors

Paula Krakowiak

Cheryl K Walker

Andrew A Bremer

Alice S Baker

Sally Ozonoff

Robin L Hansen

Irva Hertz-Picciotto

Affiliations

Soon will be listed here.

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.

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References

Ratzon N, Greenbaum C, Dulitzky M, Ornoy A . Comparison of the motor development of school-age children born to mothers with and without diabetes mellitus. Phys Occup Ther Pediatr. 2001; 20(1):43-57. View

Greenland S, Pearl J, Robins J . Causal diagrams for epidemiologic research. Epidemiology. 1999; 10(1):37-48. View

Bhasin T, Brocksen S, Avchen R, Braun K . Prevalence of four developmental disabilities among children aged 8 years--Metropolitan Atlanta Developmental Disabilities Surveillance Program, 1996 and 2000. MMWR Surveill Summ. 2006; 55(1):1-9. View

Hertz-Picciotto I, Delwiche L . The rise in autism and the role of age at diagnosis. Epidemiology. 2009; 20(1):84-90. PMC: 4113600. DOI: 10.1097/EDE.0b013e3181902d15. View

Hultman C, Sparen P, Cnattingius S . Perinatal risk factors for infantile autism. Epidemiology. 2002; 13(4):417-23. DOI: 10.1097/00001648-200207000-00009. View

Hertz-Picciotto I, Croen L, Hansen R, Jones C, Van de Water J, Pessah I . The CHARGE study: an epidemiologic investigation of genetic and environmental factors contributing to autism. Environ Health Perspect. 2006; 114(7):1119-25. PMC: 1513329. DOI: 10.1289/ehp.8483. View

Olefsky J, Glass C . Macrophages, inflammation, and insulin resistance. Annu Rev Physiol. 2010; 72:219-46. DOI: 10.1146/annurev-physiol-021909-135846. View

. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2009; 32 Suppl 1:S62-7. PMC: 2613584. DOI: 10.2337/dc09-S062. View

. Prevalence of autism spectrum disorders - Autism and Developmental Disabilities Monitoring Network, United States, 2006. MMWR Surveill Summ. 2009; 58(10):1-20. View

10.

Newschaffer C, Croen L, Daniels J, Giarelli E, Grether J, Levy S . The epidemiology of autism spectrum disorders. Annu Rev Public Health. 2007; 28:235-58. DOI: 10.1146/annurev.publhealth.28.021406.144007. View

11.

deRegnier R, Nelson C, Thomas K, Wewerka S, Georgieff M . Neurophysiologic evaluation of auditory recognition memory in healthy newborn infants and infants of diabetic mothers. J Pediatr. 2000; 137(6):777-84. DOI: 10.1067/mpd.2000.109149. View

12.

Deboer T, Wewerka S, Bauer P, Georgieff M, Nelson C . Explicit memory performance in infants of diabetic mothers at 1 year of age. Dev Med Child Neurol. 2005; 47(8):525-31. PMC: 2829746. DOI: 10.1017/s0012162205001039. View

13.

Flegal K, Carroll M, Ogden C, Curtin L . Prevalence and trends in obesity among US adults, 1999-2008. JAMA. 2010; 303(3):235-41. DOI: 10.1001/jama.2009.2014. View

14.

Georgieff M . The effect of maternal diabetes during pregnancy on the neurodevelopment of offspring. Minn Med. 2006; 89(3):44-7. View

15.

Jonakait G . The effects of maternal inflammation on neuronal development: possible mechanisms. Int J Dev Neurosci. 2007; 25(7):415-25. DOI: 10.1016/j.ijdevneu.2007.08.017. View

16.

Leonard H, de Klerk N, Bourke J, Bower C . Maternal health in pregnancy and intellectual disability in the offspring: a population-based study. Ann Epidemiol. 2005; 16(6):448-54. DOI: 10.1016/j.annepidem.2005.05.002. View

17.

Rizzo T, Metzger B, Dooley S, Cho N . Early malnutrition and child neurobehavioral development: insights from the study of children of diabetic mothers. Child Dev. 1997; 68(1):26-38. View

18.

Matson J, Shoemaker M . Intellectual disability and its relationship to autism spectrum disorders. Res Dev Disabil. 2009; 30(6):1107-14. DOI: 10.1016/j.ridd.2009.06.003. View

19.

Ferrannini E, Haffner S, Stern M . Essential hypertension: an insulin-resistant state. J Cardiovasc Pharmacol. 1990; 15 Suppl 5:S18-25. View

20.

Yeargin-Allsopp M, Murphy C, Cordero J, DECOUFLE P, Hollowell J . Reported biomedical causes and associated medical conditions for mental retardation among 10-year-old children, metropolitan Atlanta, 1985 to 1987. Dev Med Child Neurol. 1997; 39(3):142-9. DOI: 10.1111/j.1469-8749.1997.tb07401.x. View