Severe maternal childhood abuse associated with autism in offspring

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1. Women who were severely abused (sexually, physically, and/or emotionally) in childhood were more likely to have children diagnosed with autism when compared to women with no abuse history.

2. An intergenerational relationship between maternal childhood abuse and development of autism in offspring may exist.

An intergenerational relationship between maternal childhood abuse and development of autism in offspring may exist. This study showed that maternal exposure to any type of childhood abuse was associated with a positive dose-response effect on risk for autism disorders, which was significant only in women who survived the highest level of abuse. These results suggest there may be a need for increased supportive measures for pregnant women with an abuse history.

Generalizability could be limited because the population was largely white (97%) and relied on self-reporting of childhood abuse, autism in offspring, and perinatal factors, which could overestimate findings despite multiple validation studies for questionnaires assessing exposure and outcome and a high (84.1%) response rates from autism questionnaires. Strengths of this investigation include a large sample size, prospectively-collected data, similarity of controls to cases, inclusion of study of perinatal risk factors, as well as validation of a subset of reported autism cases.

Click to read the study in JAMA Psychiatry

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1. Women who were severely abused (sexual, physical, and emotional combined) in childhood were more likely to have children diagnosed with autism when compared to women with no abuse history. 

2. An intergenerational relationship between maternal childhood abuse and development of autism in offspring may exist.

This [nested case-control study] study examined the relationship between maternal childhood abuse and risk for autism in offspring, using data from 54,963 nurses from the Nurses Health II longitudinal cohort. Cases were confirmed in 2005 via two questionnaires, resulting in n=451 women with autistic children (cases) and n=54,498 controls. Abuse history was elicited in 2001 via questionnaire and was categorized into 3 groups for analysis (sexual; physical and emotional; combined emotional, physical, sexual) and by severity (scale of 0-6; and divided into quartiles to assess for dose-response).

Compared to women with no history of abuse, women with the highest level of childhood abuse were more likely to have children with a diagnosed autism disorder (RR:3.7; CI: 2.3-5.8; p<0.001). When adjusting for perinatal risk factors, such as gestational diabetes or partner abuse, severely abused women remained more likely to have a child with autism when compared to non-abused women (RR: 3.0; CI: 1.9-4.8, p<0.001).

In sum: An intergenerational relationship between maternal childhood abuse and development of autism in offspring may exist. This study showed that maternal exposure to any type of childhood abuse was associated with a positive dose-response effect on risk for autism disorders, which was significant only in women who survived the highest level of abuse. These results suggest there may be a need for increased supportive measures for pregnant women with an abuse history.

Generalizability could be limited because the population was largely white (97%) and relied on self-reporting of childhood abuse, autism in offspring, and perinatal factors, which could overestimate findings despite multiple validation studies for questionnaires assessing exposure and outcome and a high (84.1%) response rates from autism questionnaires. Strengths of this investigation include a large sample size, prospectively-collected data, similarity of controls to cases, inclusion of study of perinatal risk factors, as well as validation of a subset of reported autism cases.

Click to read the study in JAMA Psychiatry 

By Caroline Huang and Leah Hawkins

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