Maternal risk factors vary between subpopulations of children with autism spectrum disorder

Area of Science:

• Developmental Pediatrics
• Autism Spectrum Disorder Research
• Prenatal Risk Factor Analysis

Background:

• Previous research classified children with autism spectrum disorder (ASD) into three subgroups based on co-occurring conditions (COCs) within the first five years of life.
• Understanding the prenatal origins of these subgroups is crucial for addressing ASD heterogeneity.

Purpose of the Study:

• To investigate distinct prenatal risk factors associated with three previously identified ASD subgroups: High-Prevalence COCs, Developmental Delay/Seizure (DD/Seizure) COCs, and Low-Prevalence COCs.
• To determine if prenatal risk factors differ across these ASD subgroups.

Main Methods:

• Utilized maternal medical claims data to identify prenatal risk factors.
• Analyzed risk factors in relation to the three distinct ASD subgroups defined by co-occurring conditions.

Main Results:

• Identified shared and unique prenatal risk factors across the three ASD subgroups.
• High-Prevalence COCs subgroup associated with infections, anti-inflammatory, and complex medications.
• DD/Seizure COCs subgroup linked to immune deregulatory conditions (e.g., asthma, joint disorders).
• Low-Prevalence COCs subgroup associated with overall pregnancy complications.

Conclusions:

• Children with ASD exhibit distinct prenatal risk factor profiles corresponding to their co-occurring condition subgroups.
• Subgrouping children with ASD based on COCs provides a potential framework for understanding ASD heterogeneity.
• Findings support the clinical relevance of identifying specific prenatal exposures for different ASD presentations.