Maternal autistic traits may be associated with greater risk of adverse birth outcomes

1. A cohort study found that increased maternal autistic traits were associated with a greater risk of adverse birth outcomes.

2. Women who scored in the clinical range for AQ-J10 were more likely to be young and have higher levels of psychological distress.

Evidence Rating Level: 1 (Excellent)

Autism spectrum disorder (ASD) is a neurological and developmental disorder affecting individuals throughout their life and is characterized by different communication mechanisms and repetitive actions. Recent study findings have indicated that women with ASD may experience health challenges while pregnant, including inadequate access to care, chronic health conditions, higher stress levels and a greater risk of pregnancy complications. As there are limitations in previous studies, this study aimed to focus on women with ASD traits rather than only those diagnosed with ASD. Focusing on women with ASD traits helped the researchers not only to determine if there was an association with health challenges but also to provide support to pregnant women with ASD, regardless of receiving a formal diagnosis. The goal was to look at the association between maternal autistic traits and birth outcomes. The maternal autistic traits were measured during the second and third trimesters. A total of 87687 women (mean [SD] age, 31.2 [5.0] years) were recruited for between January 2011 and March 2014. The Autism-Spectrum Quotient Japanese version (AQ-J10) was used to measure maternal autistic traits through a self-reported questionnaire using only ten items with answers measured on a 4-point Likert scale. Scoring higher on the test indicated a higher level of autistic traits in the mother. The test reported a sensitivity of 0.76 and a specificity of 0.90. for the sample, the mean (SD) AQ-J10 score was 2.8 (1.7) with 2350 (2.7%) scoring above the threshold, however, only 18 (0.02%) of these women were diagnosed with ASD. Women who scored within the clinical range were more likely to be younger, have a lower education attained, smoked during pregnancy, and had higher distress scores compared to the women below the clinical range. A 1-SD increase in AJ-Q10 score was correlated with an increased risk of preterm births, moderate-to-late preterm births (), very preterm births, and SGA infants (RR per 1-SD). The higher the level of maternal autistic traits, the greater the risk of being preterm (RR, 1.16;95% confidence interval {CI}, 1.06-1.26), moderate-to-late preterm (RR, 1.12; 95% CI, 1.03-1.22), very preterm (RR, 1.49; 95% CI, 1.18-1.89) or small for gestational age (SGA) (RR, 1.11, 95% CI, 1.04-1.19). Very preterm birth had the highest relative risk (RR) found (RR, 1.16; 95% CI, 1.06-1.26). For all the outcomes, there was a higher probability associated with a higher level of maternal autistic traits. Overall, the findings show that women with higher levels of autistic traits were associated with having a higher risk of adverse birth outcomes.

Click to read the study in JAMA Network Open

Image: PD

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