Association between preeclampsia and autism spectrum disorder: a population-based study

Area of Science:

• Neurodevelopmental disorders
• Perinatal medicine
• Environmental risk factors

Background:

• Autism spectrum disorder (ASD) has a significant environmental contribution (17%-50%).
• Understanding ASD pathogenesis and contributing factors is crucial.
• Preeclampsia is a pregnancy complication requiring further investigation for its role in ASD.

Purpose of the Study:

• To investigate the association between preeclampsia and ASD.
• To examine if placental dysfunction, indicated by preeclampsia with small for gestational age (SGA), modifies this association.

Main Methods:

• Population-based cohort study in Sweden (1982-2010).
• Included 2,842,230 singleton live births with 54,071 ASD cases.
• Used Cox regression and sibling-matched analysis, adjusting for confounders.

Main Results:

• Preeclampsia exposure showed a 25% increased likelihood of ASD (HR: 1.25).
• Preeclampsia with SGA combined showed a significantly higher risk (HR: 1.66 in adjusted, 1.95 in sibling-matched).
• Sibling-matched analysis confirmed associations (HR: 1.17 for preeclampsia, 1.95 for preeclampsia/SGA).

Conclusions:

• Exposure to preeclampsia is associated with an increased likelihood of ASD.
• The stronger association with preeclampsia/SGA suggests placental pathology as a potential mechanism.
• Findings highlight the importance of monitoring pregnancies with preeclampsia for potential neurodevelopmental outcomes.