Uncovering Prenatal Risk Factors for Autism

Anna Tarasova ‘19

Figure 1. Some mental disorders may have prenatal risk factors.

Autism spectrum disorder (ASD) is a mental disorder that affects 1 in 59 children, according to an estimate by the Centers for Disease Control and Prevention (CDC). More than 3.5 million Americans are currently living with ASD. As such, it is vital to study the risk factors that could be affecting the prevalence of this disorder. An association has previously been found between maternal type 2 diabetes (T2D) and child ASD as well as maternal gestational diabetes mellitus (GDM). Dr. Anny Xiang and her team at Kaiser Permanente Southern California elaborates on this past research by conducting a retrospective cohort study examining the potential effects of maternal type 1 diabetes (T1D) on ASD in offspring.

Using a sample of 419,425 children, 51% of whom were boys, the researchers used statistical analyses to determine the strength of the association between maternal T1D and offspring ASD. Several potential confounds were identified, including birth year, maternal age at delivery, education, and self-reported race/ethnicity. 621 mothers in the sample were diagnosed with T1D, 9435 with T2D, 11,922 with GDM by 26 weeks of gestation, and 24,505 with GDM after 26 weeks. The follow-up was conducted a median of 6.9 years later. A total of 5827 children were diagnosed with ASD. The average annual ASD incidence rate for every 1000 children were 4.4, 3.6, 2.9, 2.1, and 1.8 respectively for mothers with T1D, T2D, GDM by 26 weeks, GDM after 26 weeks, and no diabetes. The results were adjusted to control for maternal smoking and pre-pregnancy BMI, but this did not significantly affect the conclusions of the study. The researchers concluded that the severity of maternal diabetes may be a strong risk factor for ASD in offspring. Other risk factors, as well as the mechanism of the relationship between diabetes and ASD, remain to be studied.



  1. A. Xiang et. al., Maternal type 1 diabetes and risk of autism in offspring. JAMA Research Letters (2018). doi: 10.1001/jama.2018.7614.  
  2. Image retrieved from: https://www.publicdomainpictures.net/pictures/50000/velka/pregnancy.jpg#.Wzg4p8-HY_A.link

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