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Mediators of the association between parental severe mental illness and offspring neurodevelopmental problems
Brittany M McCoy1, Martin E Rickert1, Quetzal A Class1
1Department of Psychological and Brain Sciences, Indiana University Bloomington, Bloomington.
Insights
Parental severe mental illness (SMI) increases offspring autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) risk. However, adverse pregnancy outcomes do not mediate this link, acting as independent risk factors.
Area of Science:
- Psychiatry
- Developmental Pediatrics
- Epidemiology
Background:
- Parental severe mental illness (SMI) is a known risk factor for neurodevelopmental disorders in offspring.
- Autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) are complex conditions with multifactorial etiologies.
- The role of intermediate factors, such as adverse pregnancy outcomes, in this association requires further elucidation.
Purpose of the Study:
- To investigate whether adverse pregnancy outcomes mediate the association between parental severe mental illness (SMI) and the risk of offspring autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD).
Main Methods:
- Utilized Swedish population-based registry data from 1992-2001 (n=870,017 offspring).
- Employed logistic and Cox regression models to assess associations between parental SMI, pregnancy outcomes (preterm birth, low birth weight, small for gestational age), and offspring ASD/ADHD.
- Performed mediation analyses to determine the role of pregnancy outcomes.
Main Results:
- Parental SMI was significantly associated with increased risks of preterm birth, low birth weight, and offspring ASD and ADHD.
- Adverse pregnancy outcomes were independently associated with increased risks of ASD and ADHD.
- Mediation analysis revealed no substantial change in risk estimates, indicating pregnancy outcomes do not mediate the parental SMI-offspring neurodevelopmental disorder link.
Conclusions:
- Parental severe mental illness (SMI) and adverse pregnancy outcomes are independent risk factors for autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) in offspring.
- These findings highlight distinct pathways contributing to the development of ASD and ADHD.
Purpose:
Parental severe mental illness (SMI) is associated with an increased risk of offspring autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). We conducted a study to examine the extent to which risk of preterm birth, low birth weight, and small for gestational age mediated this association.
Methods:
We obtained data on offspring born 1992-2001 in Sweden (n = 870,017) through the linkage of multiple population-based registers. We used logistic and Cox regression to assess the associations between parental SMI, adverse pregnancy outcomes, and offspring ASD and ADHD, as well as tested whether adverse pregnancy outcomes served as mediators.
Results:
After controlling for measured covariates, maternal and paternal SMI were associated with an increased risk for preterm birth, low birth weight, and gestational age, and for offspring ASD and ADHD. These pregnancy outcomes were also associated with an increased risk of ASD and ADHD. We found that pregnancy outcomes did not mediate the association between parental SMI and offspring ASD and ADHD, as there was no substantial change in magnitude of the risk estimates after controlling for pregnancy outcomes.
Conclusions:
Parental SMI and adverse pregnancy outcomes appear to be independent risk factors for offspring ASD and ADHD.
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