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.
Abstract

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