Adverse birth outcome risks increase with maternal autistic traits

Key takeaways:

• Women with more autistic traits had increased risks for preterm birth and small for gestational age neonates.
• Risks for all adverse birth outcomes increased with higher maternal autistic traits levels.

Women with more autistic traits during pregnancy had higher risks for adverse birth outcomes, especially for preterm birth, compared with lower levels of autistic traits, researchers reported in JAMA Network Open.

“Given that women with an elevated level of autistic traits are less likely to receive a formal diagnosis than men, which may create further challenges in gaining support, there is a need to investigate the association between maternal autistic traits in the general population and adverse birth outcomes,” Mariko Hosozawa, MD, PhD, from the Institute for Global Health Policy Research at the Bureau of International Health Cooperation at the National Center for Global Health and Medicine, Tokyo, and colleagues wrote. “This approach will help identify women who need additional support during pregnancy regardless of having received a formal diagnosis of autism spectrum disorder, with the potential to improve maternal and child outcomes.”

Hosozawa and colleagues conducted a cohort study with data from 87,687 women (mean age, 31.2 years) from the nationwide, multicenter prospective Japan Environment and Children’s Study birth cohort who had singleton births from 2011 to March 2014. Researchers collected self-reported autistic traits during the second and third trimesters using the short form of the Autism-Spectrum Quotient Japanese (AQ-J10) version.

The primary outcomes were data on preterm birth and small for gestational age neonates.

Overall, 2.7% of women had AQ-J10 scores within the clinical range, but only 0.02% of women were diagnosed with autism spectrum disorder. The mean AQ-J10 score within the cohort was 2.8.

When adjusting for maternal and pregnancy-related factors, higher AQ-J10 scores were associated with increased risks for all birth outcomes, including preterm birth (RR = 1.06; 95% CI, 1.03-1.09), moderate to late preterm birth (RR = 1.05; 95% CI, 1.01-1.08), very preterm birth (RR = 1.16; 95% CI, 1.06-1.26) and small for gestational age neonates (RR = 1.04; 95% CI, 1.01-1.06).

Risks for all adverse birth outcomes increased with higher AQ-J10 scores. Women with scores within the clinical range had higher risks for preterm birth (RR = 1.16; 95% CI, 1.07-1.26, moderate to late preterm birth (RR = 1.12; 95% CI, 1.03-1.22), very preterm birth (RR = 1.49; 95% CI, 1.18-1.89) and small for gestational age neonates (RR = 1.11; 95% CI, 1.04-1.19) compared with women with scores below the clinical range.

“Comprehensive antenatal care including the assessment of antenatal psychological distress and offering timely and tailored support that meets the needs of women should be provided inclusively regardless of whether a formal diagnosis of autism spectrum disorder is received,” the researchers wrote. “If provided, these approaches may improve maternal well-being with the potential to reduce the risk of adverse birth outcomes and have a downstream effect on child health and development.”