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Cross-Setting Replication of the Associations Between Maternal Health and Autism.

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Maternal health conditions during pregnancy were linked to autism risk in a US study, replicating findings from a Danish cohort. This suggests these associations are relevant across different populations and healthcare settings.

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Area of Science:

  • Neurodevelopmental disorders
  • Reproductive health

Background:

  • Autism spectrum disorder (ASD) is a neurodevelopmental condition with early-life origins.
  • Maternal health during pregnancy is a potential factor influencing autism risk.
  • Previous studies on maternal health and ASD risk have often been limited to single populations, hindering generalizability.

Purpose of the Study:

  • To investigate the generalizability of previously reported associations between maternal health conditions and autism risk.
  • To compare findings from a US cohort with a Danish registry-based study.

Main Methods:

  • Analysis of electronic health records for children born between 2010-2017 at Kaiser Permanente Northern California (KPNC).
  • Classification of maternal diagnoses as chronic or non-chronic.
  • Use of Cox models to assess associations between maternal diagnoses and child ASD, adjusting for sociodemographic factors, healthcare utilization, and comorbid maternal diagnoses.
  • Alignment of methods with a prior Danish study for comparability.

Main Results:

  • Among 224,353 children, 2.4% were diagnosed with ASD.
  • Of 42 maternal diagnoses associated with autism in Denmark, 38 were evaluable in the KPNC cohort.
  • 18 maternal diagnoses remained statistically significant after adjustment in the US cohort.
  • Most associations showed consistent point estimates with the Danish study, particularly for psychiatric and cardiometabolic conditions.

Conclusions:

  • A significant proportion (35 of 38) of maternal health condition associations with autism found in a Danish study replicated qualitatively in a US cohort.
  • These findings suggest robust cross-setting relevance of maternal health conditions as potential risk factors for autism spectrum disorder.
  • Further research is warranted to elucidate underlying biological mechanisms and identify potential effect modifiers.