Pregnancy Planning and Its Association with Autism Spectrum Disorder: Findings from the Study to Explore Early Development

Overview

Journal Matern Child Health J

Specialty Health Services

Date 2024 Jan 10

PMID 38198102

Authors

Shericka T Harris

Laura A Schieve

Carolyn Drews-Botsch

Carolyn DiGuiseppi

Lin H Tian

Gnakub N Soke

Chyrise B Bradley

Gayle C Windham

Affiliations

Soon will be listed here.

Abstract

Objectives: To examine associations between pregnancy planning and autism spectrum disorder (ASD) in offspring.

Methods: The Study to Explore Early Development (SEED), a multi-site case-control study, enrolled preschool-aged children with ASD, other DDs, and from the general population (POP). Some children with DDs had ASD symptoms but did not meet the ASD case definition. We examined associations between mother's report of trying to get pregnant (pregnancy planning) and (1) ASD and (2) ASD symptomatology (ASD group, plus DD with ASD symptoms group combined) (each vs. POP group). We computed odds ratios adjusted for demographic, maternal, health, and perinatal health factors (aORs) via logistic regression. Due to differential associations by race-ethnicity, final analyses were stratified by race-ethnicity.

Results: Pregnancy planning was reported by 66.4%, 64.8%, and 76.6% of non-Hispanic White (NHW) mothers in the ASD, ASD symptomatology, and POP groups, respectively. Among NHW mother-child pairs, pregnancy planning was inversely associated with ASD (aOR = 0.71 [95% confidence interval 0.56-0.91]) and ASD symptomatology (aOR = 0.67 [0.54-0.84]). Pregnancy planning was much less common among non-Hispanic Black mothers (28-32% depending on study group) and Hispanic mothers (49-56%) and was not associated with ASD or ASD symptomatology in these two race-ethnicity groups.

Conclusion: Pregnancy planning was inversely associated with ASD and ASD symptomatology in NHW mother-child pairs. The findings were not explained by several adverse maternal or perinatal health factors. The associations observed in NHW mother-child pairs did not extend to other race-ethnicity groups, for whom pregnancy planning was lower overall.

References

Schieve L . Multiple-gestation pregnancies after assisted reproductive technology treatment: population trends and future directions. Womens Health (Lond). 2009; 3(3):301-7. DOI: 10.2217/17455057.3.3.301. View

Schendel D, DiGuiseppi C, Croen L, Daniele Fallin M, Reed P, Schieve L . The Study to Explore Early Development (SEED): a multisite epidemiologic study of autism by the Centers for Autism and Developmental Disabilities Research and Epidemiology (CADDRE) network. J Autism Dev Disord. 2012; 42(10):2121-40. PMC: 4455890. DOI: 10.1007/s10803-012-1461-8. View

Daly M, Kipping R, Tinner L, Sanders J, White J . Preconception exposures and adverse pregnancy, birth and postpartum outcomes: Umbrella review of systematic reviews. Paediatr Perinat Epidemiol. 2021; 36(2):288-299. DOI: 10.1111/ppe.12855. View

Gutvirtz G, Wainstock T, Landau D, Sheiner E . Maternal smoking during pregnancy and long-term neurological morbidity of the offspring. Addict Behav. 2018; 88:86-91. DOI: 10.1016/j.addbeh.2018.08.013. View

Schmidt R, Tancredi D, Ozonoff S, Hansen R, Hartiala J, Allayee H . Maternal periconceptional folic acid intake and risk of autism spectrum disorders and developmental delay in the CHARGE (CHildhood Autism Risks from Genetics and Environment) case-control study. Am J Clin Nutr. 2012; 96(1):80-9. PMC: 3374734. DOI: 10.3945/ajcn.110.004416. View

Cheng D, Schwarz E, Douglas E, Horon I . Unintended pregnancy and associated maternal preconception, prenatal and postpartum behaviors. Contraception. 2009; 79(3):194-8. DOI: 10.1016/j.contraception.2008.09.009. View

Joyce T, Kaestner R, Korenman S . The stability of pregnancy intentions and pregnancy-related maternal behaviors. Matern Child Health J. 2000; 4(3):171-8. DOI: 10.1023/a:1009571313297. View

Arndt T, Stodgell C, Rodier P . The teratology of autism. Int J Dev Neurosci. 2005; 23(2-3):189-99. DOI: 10.1016/j.ijdevneu.2004.11.001. View

Kim Y, Leventhal B . Genetic epidemiology and insights into interactive genetic and environmental effects in autism spectrum disorders. Biol Psychiatry. 2014; 77(1):66-74. PMC: 4260177. DOI: 10.1016/j.biopsych.2014.11.001. View

10.

Guinchat V, Thorsen P, Laurent C, Cans C, Bodeau N, Cohen D . Pre-, peri- and neonatal risk factors for autism. Acta Obstet Gynecol Scand. 2011; 91(3):287-300. DOI: 10.1111/j.1600-0412.2011.01325.x. View

11.

Santelli J, Rochat R, Hatfield-Timajchy K, Gilbert B, Curtis K, Cabral R . The measurement and meaning of unintended pregnancy. Perspect Sex Reprod Health. 2003; 35(2):94-101. DOI: 10.1363/3509403. View

12.

. ACOG Committee Opinion No. 762: Prepregnancy Counseling. Obstet Gynecol. 2018; 133(1):e78-e89. DOI: 10.1097/AOG.0000000000003013. View

13.

Kim T, Dagher R, Chen J . Racial/Ethnic Differences in Unintended Pregnancy: Evidence From a National Sample of U.S. Women. Am J Prev Med. 2015; 50(4):427-435. DOI: 10.1016/j.amepre.2015.09.027. View

14.

Finer L, Zolna M . Unintended pregnancy in the United States: incidence and disparities, 2006. Contraception. 2011; 84(5):478-85. PMC: 3338192. DOI: 10.1016/j.contraception.2011.07.013. View

15.

Robbins C, Boulet S, Morgan I, DAngelo D, Zapata L, Morrow B . Disparities in Preconception Health Indicators -  Behavioral Risk Factor Surveillance System, 2013-2015, and Pregnancy Risk Assessment Monitoring System, 2013-2014. MMWR Surveill Summ. 2018; 67(1):1-16. PMC: 5829866. DOI: 10.15585/mmwr.ss6701a1. View

16.

Finer L, Zolna M . Declines in Unintended Pregnancy in the United States, 2008-2011. N Engl J Med. 2016; 374(9):843-52. PMC: 4861155. DOI: 10.1056/NEJMsa1506575. View

17.

Wiggins L, Reynolds A, Rice C, Moody E, Bernal P, Blaskey L . Using standardized diagnostic instruments to classify children with autism in the study to explore early development. J Autism Dev Disord. 2014; 45(5):1271-80. PMC: 4486213. DOI: 10.1007/s10803-014-2287-3. View

18.

Hus Y, Segal O . Challenges Surrounding the Diagnosis of Autism in Children. Neuropsychiatr Dis Treat. 2021; 17:3509-3529. PMC: 8654688. DOI: 10.2147/NDT.S282569. View

19.

Wiggins L, Levy S, Daniels J, Schieve L, Croen L, DiGuiseppi C . Autism spectrum disorder symptoms among children enrolled in the Study to Explore Early Development (SEED). J Autism Dev Disord. 2015; 45(10):3183-94. PMC: 4573234. DOI: 10.1007/s10803-015-2476-8. View

20.

Dehlendorf C, Rodriguez M, Levy K, Borrero S, Steinauer J . Disparities in family planning. Am J Obstet Gynecol. 2010; 202(3):214-20. PMC: 2835625. DOI: 10.1016/j.ajog.2009.08.022. View