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Prenatal and birth factors associated with child autism diagnosis: a birth cohort perspective
Lada Holland1, Katherine Drummond1, Sarah Thomson1
1The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia.
Insights
Prenatal factors like maternal health and environmental exposures are linked to autism risk. Good nutrition during pregnancy may reduce this risk, suggesting a multifactorial origin for autism spectrum disorder.
Area of Science:
- Neurodevelopmental disorders
- Public Health
- Environmental Epidemiology
Background:
- Autism spectrum disorder (ASD) is a complex neurodevelopmental condition.
- Its etiology involves interactions between genetic and environmental factors.
- Understanding these factors is crucial for early identification and intervention.
Purpose of the Study:
- To identify prospective associations between prenatal and birth factors and autism diagnosis.
- To explore the multifactorial origins of autism spectrum disorder.
Main Methods:
- A scoping approach was used in a general population birth cohort.
- Prospective associations between prenatal/birth factors and autism diagnosis were identified.
Main Results:
- Increased autism likelihood associated with maternal pre-pregnancy BMI, pre-existing maternal mental health conditions, SSRI use, passive smoke exposure, vinyl floor exposure, and socioeconomic disadvantage.
- Decreased autism likelihood associated with maternal nutrition (folic acid, magnesium, iron) and adherence to dietary guidelines.
Conclusions:
- Autism has multifactorial origins, influenced by prenatal and birth factors.
- Prenatal nutrition, like adherence to dietary guidelines, may reduce autism risk.
- Future research should investigate shared biological pathways (e.g., inflammation, oxidative stress) linking these factors to autism.
Background:
Autism spectrum disorder (autism) describes a heterogeneous neurodevelopmental phenotype arising from the interplay of environmental and genetic factors in early life.
Methods:
In a general population birth cohort, we employed a scoping approach to identify prospective associations between prenatal and birth factors and a subsequent autism diagnosis.
Results:
Factors associated with increased likelihood of autism included those related to i) maternal health (maternal pre-pregnancy body mass index, pre-existing maternal mental health conditions, maternal use of selective serotonin reuptake inhibitors) ii) environmental exposures (maternal passive tobacco smoke exposure, and exposure to vinyl floors) iii) demographic factors (socioeconomic disadvantage). Factors associated with a decreased likelihood of autism included maternal dietary nutrition and supplementation (higher folic acid, magnesium, and iron, as well as adherence to the Australian Dietary Guidelines).
Conclusion:
Our findings extend the evidence that autism may have a multifactorial origin in early life. Further studies should explore the composite effects of these prenatal and birth factors on autism outcomes via shared biological pathways, such as inflammation, and oxidative stress, in concert with genetic predisposition.
Impact:
Autism spectrum disorder (autism) is a multifactorial condition. Here we report on multiple prenatal environmental, demographic, maternal and pregnancy factors that are associated with an increased likelihood of an autism diagnosis. For example, adherence to the Australian Dietary Guidelines during pregnancy is linked to a reduced likelihood of autism in the offspring, consistent with mounting evidence that prenatal nutrition impacts brain development. We examine how the multiple risk factors, identified by our comprehensive approach, may be linked to shared biological mechanisms. Future work should examine composite exposure measures acting through shared mechanisms as a more productive approach to understanding aetiology than focusing solely on individual exposures.
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