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Maternal vitamin D during pregnancy and offspring autism and autism-associated traits: a prospective cohort study
Paul Madley-Dowd1,2, Christina Dardani3, Robyn E Wootton4,5,6
1Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK. p.madley-dowd@bristol.ac.uk.
Insights
This study found no strong evidence linking maternal vitamin D levels during pregnancy to offspring autism diagnosis or traits. Further research is needed to explore potential subtle associations and causal relationships.
Area of Science:
- Perinatal health
- Neurodevelopmental disorders
- Nutritional epidemiology
Background:
- Growing interest in maternal vitamin D and offspring autism risk.
- Previous studies show inconclusive evidence regarding causality.
Purpose of the Study:
- To investigate the association between maternal vitamin D levels during pregnancy and autism in offspring.
- To determine if any observed associations are causal.
Main Methods:
- Utilized data from the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort.
- Employed regression models and Mendelian randomization to assess associations and causality.
- Analyzed maternal serum 25-hydroxyvitamin D levels and offspring autism diagnosis/traits.
Main Results:
- No strong evidence of association between maternal vitamin D and offspring autism diagnosis or traits.
- Mendelian randomization did not suggest a causal effect.
- Spline analysis indicated potential increased odds of autism traits at lower maternal vitamin D levels.
Conclusions:
- No robust evidence for a causal link between maternal vitamin D in pregnancy and offspring autism.
- Study limitations include potential low power and residual confounding.
Background:
There has been a growing interest in the association between maternal levels of vitamin D during pregnancy and offspring autism. However, whether any associations reflect causal effects is still inconclusive.
Methods:
We used data from a UK-based pregnancy cohort study (Avon Longitudinal Study of Parents and Children) comprising 7689 births between 1991 and 1992 with maternal blood vitamin D levels recorded during pregnancy and at least one recorded outcome measure, including autism diagnosis and autism-associated traits. The association between each outcome with seasonal and gestational age-adjusted maternal serum 25-hydroxyvitamin D during pregnancy was estimated using confounder-adjusted regression models. Multiple imputation was used to account for missing data, and restricted cubic splines were used to investigate nonlinear associations. Mendelian randomization was used to strengthen causal inference.
Results:
No strong evidence of an association between maternal serum 25-hydroxyvitamin D during pregnancy and any offspring autism-associated outcome was found using multivariable regression analysis (autism diagnosis: adjusted OR = 0.98, 95% CI = 0.90-1.06), including with multiple imputation (autism diagnosis: adjusted OR = 0.99, 95% CI = 0.93-1.06), and no evidence of a causal effect was suggested by Mendelian randomization (autism diagnosis: causal OR = 1.08, 95% CI = 0.46-2.55). Some evidence of increased odds of autism-associated traits at lower levels of maternal serum 25-hydroxyvitamin D was found using spline analysis.
Limitations:
Our study was potentially limited by low power, particularly for diagnosed autism cases as an outcome. The cohort may not have captured the extreme lows of the distribution of serum 25-hydroxyvitamin D, and our analyses may have been biased by residual confounding and missing data.
Conclusions:
The present study found no strong evidence of a causal link between maternal vitamin D levels in pregnancy and offspring diagnosis or traits of autism.
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