Infection and Fever in Pregnancy and Autism Spectrum Disorders: Findings from the Study to Explore Early Development

Details

• Alternative Title:
  Autism Res
• Personal Author:
  Croen, Lisa A. ; Qian, Yinge ; Ashwood, Paul ; Zerbo, Ousseny ; Schendel, Diana ; Pinto-Martin, Jennifer ; Fallin, M. Daniele ; Levy, Susan ; Schieve, Laura A. ; Yeargin-Allsopp, Marshalyn ; Sabourin, Katherine R. ; Ames, Jennifer L.
• Description:
  Maternal infection and fever during pregnancy have been implicated in the etiology of autism spectrum disorder (ASD); however, studies have not been able to separate the effects of fever itself from the impact of a specific infectious organism on the developing brain. We utilized data from the Study to Explore Early Development (SEED), a case-control study among 2- to 5-year-old children born between 2003 and 2006 in the United States, to explore a possible association between maternal infection and fever during pregnancy and risk of ASD and other developmental disorders (DDs). Three groups of children were included: children with ASD (N = 606) and children with DDs (N = 856), ascertained from clinical and educational sources, and children from the general population (N = 796), randomly sampled from state birth records. Information about infection and fever during pregnancy was obtained from a telephone interview with the mother shortly after study enrollment and maternal prenatal and labor/delivery medical records. ASD and DD status was determined by an in-person standardized developmental assessment of the child at 3-5 years of age. After adjustment for covariates, maternal infection anytime during pregnancy was not associated with ASD or DDs. However, second trimester infection accompanied by fever elevated risk for ASD approximately twofold (aOR = 2.19, 95% confidence interval 1.14-4.23). These findings of an association between maternal infection with fever in the second trimester and increased risk of ASD in the offspring suggest that the inflammatory response to the infectious agent may be etiologically relevant. Autism Res 2019, 12: 1551-1561. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Using data from a large multisite study in the United States-the Study to Explore Early Development-we found that women who had an infection during the second trimester of pregnancy accompanied by a fever are more likely to have children with ASD. These findings suggest the possibility that only more severe infections accompanied by a robust inflammatory response increase the risk of ASD.
• Subjects:
  Adult Article Autism Autism Spectrum Disorder Case-Control Studies Child, Preschool Comorbidity Developmental Disorder Female Fever Humans Immune Function Infection Infections Male Mothers Neurodevelopment Pregnancy Pregnancy Complications Pregnancy Trimester, Second Prenatal Risk Factors United States Young Adult

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• Source:
  Autism Res. 12(10):1551-1561
• Pubmed ID:
  31317667
• Pubmed Central ID:
  PMC7784630
• Document Type:
  Journal Article
• Funding:
  U10 DD000182/DD/NCBDD CDC HHS/United States ; R21 HD086669/HD/NICHD NIH HHS/United States ; U01 DD000498/DD/NCBDD CDC HHS/United States ; U10 DD000184/DD/NCBDD CDC HHS/United States ; U10 DD000180/DD/NCBDD CDC HHS/United States ; CC999999/ImCDC/Intramural CDC HHS/United States ; U10 DD000183/DD/NCBDD CDC HHS/United States ; U10 DD000181/DD/NCBDD CDC HHS/United States ; Michigan State University/International ; R21 MH116383/MH/NIMH NIH HHS/United States ; U01 DD001210/DD/NCBDD CDC HHS/United States
• Volume:
  12
• Issue:
  10
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:488dd954996f9c93c7d1075cdd306bf2cb540e0d0eb8fb0832853d115a3a841a
• Download URL:
  https://stacks.cdc.gov/view/cdc/99957/cdc_99957_DS1.pdf
• File Type:
  [PDF - 130.79 KB ]