Prenatal Infection and Autism Spectrum Disorders in Childhood: A Population-Based Case-Control Study in Taiwan
Shao-You Fang1,2, Sabrina Wang3, Nicole Huang1
1Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
Insights
Prenatal bacterial and genital tract infections during the third trimester were linked to a slightly increased risk of autism spectrum disorders (ASDs) in children. No significant sex differences were observed in this association.
Area of Science:
- Reproductive Health
- Neurodevelopmental Disorders
- Epidemiology
Background:
- Pregnancy infections are associated with adverse child development.
- Autism spectrum disorders (ASDs) are complex neurodevelopmental conditions.
- Understanding prenatal risk factors for ASDs is crucial.
Purpose of the Study:
- To investigate the association between prenatal infections and ASDs.
- To examine these links across different pregnancy trimesters.
- To explore potential sex-based differences in the ASDs-infection relationship.
Main Methods:
- Utilized the National Health Insurance Research Database (2000-2007).
- Included 4184 children with ASDs and 16,734 controls.
- Employed conditional logistic regression analysis adjusting for covariates.
Main Results:
- Third-trimester genital infections showed a slight association with increased ASD risk (aOR: 1.34).
- Third-trimester bacterial infections also showed a slight association with increased ASD risk (aOR: 1.24).
- No statistically significant sex differences were identified.
Conclusions:
- Provides population-based evidence linking third-trimester infections to ASD risk.
- Bacterial and genital tract infections in late pregnancy warrant further investigation as potential ASD risk factors.
- Further research is needed to explore these associations.
Background:
Infection in pregnancy has long been linked with negative postnatal development and health. This study aims to assess the association between prenatal infections and autism spectrum disorders (ASDs) across three trimesters and to probe possible sex heterogeneity in such link.
Method:
A total of 4184 children with incident ASDs and 16,734 matched children were identified from the 2000-2007 National Health Insurance Research Database. For each child, information pertaining to the mother's infection during pregnancy, sociodemographics, and medical history was retrieved from healthcare records. Conditional logistic analyses were carried out to estimate the strength of associations with adjustment for multiple comparisons.
Result:
Pooled analyses demonstrated that having two or more outpatient visits for genital infection [adjusted odds ratio (aOR): 1.34; 95% confidence interval (95% CI) 1.12, 1.60; false discovery rate (FDR) < 0.01] and bacterial infection (aOR: 1.24; 95% CI 1.06, 1.43; FDR < 0.05) in the third trimester were slightly associated with increased risk of ASDs. No statistically significant sex differences were found.
Conclusion:
The present study contributes updated population-based evidence about the connection between prenatal infection and ASDs. Potential effect of bacterial and genital tract infections during the third trimester on risk of ASDs warrants further exploration.
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