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A U.S. study of 224,353 children found that several maternal health conditions during pregnancy were associated with autism diagnoses. Associations for maternal overweight or obesity, depression, asthma and pregnancy complications were stronger among white mothers, but the study does not establish that these conditions cause autism.
A study of 224,353 children born in Northern California found that maternal health conditions during pregnancy were associated with autism diagnoses, with the strength of some associations differing by race and ethnicity. The researchers reported stronger associations among white mothers for overweight or obesity, depression, asthma and pregnancy complications; the observational findings do not show that these conditions cause autism.
Magdalena Janecka, PhD, of NYU Grossman School of Medicine and her co-authors analyzed health records for children born between 2010 and 2017 in the Kaiser Permanente Northern California system. Of the children in the study, 5,448 were diagnosed with autism. Their mean age at diagnosis was 3 years, and the mothers’ mean age at delivery was 31.9.
The researchers assessed 25 maternal diagnoses previously identified as potentially associated with autism. Most conditions showed broadly similar relationships across racial and ethnic groups. Four had statistically significant differences in association by maternal race and ethnicity: overweight or obesity, depression, asthma and pregnancy complications. The associations for these four conditions were stronger among white mothers than among Black, Hispanic, and Asian and Pacific Islander mothers.
Overall, 2.4% of children in the study were diagnosed with autism. The reported prevalence was 3.2% among Black children, 2.9% among Asian and Pacific Islander children, 2.5% among Hispanic children and 2.0% among white children. These figures describe diagnoses in this study population; they do not establish why prevalence differed or indicate that maternal conditions explain those differences. Two other factors, pain associated with female genital organs and the menstrual cycle, and bipolar disorder, did not remain statistically significant after correction for multiple testing.
How Care Access May Shape the Findings
The results matter because they show that associations between maternal health and children’s autism diagnoses may not be uniform across groups. The authors say the differences could reflect healthcare access, diagnostic practices, or unmeasured environmental and genetic factors. The study cannot determine which explanation is responsible.
In an accompanying editorial, Aisha Dickerson, PhD, MSPH, of the Johns Hopkins Bloomberg School of Public Health, emphasized that diagnoses drawn from medical records depend on people having access to care. She said the findings support attention to possible healthcare disparities and differences in diagnosis, while noting that electronic records have limits as research measures. The study may inform future work on how health systems identify and treat maternal conditions, but it does not establish a prevention strategy for autism.
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What the Study Can Establish
Earlier research has reported associations between autism in offspring and several maternal conditions, including obesity, diabetes, hypertensive disorders of pregnancy, asthma and psychiatric conditions. The current study adds an analysis of whether some associations vary by maternal race and ethnicity, rather than treating them as identical across populations.
Janecka told MedPage Today that many studies assume potential risk-factor effects are the same across groups, and that her team aimed to examine variation. She also said other dimensions, including insurance status, remain to be studied. The work is observational: it identifies patterns in health records, not a direct biological cause. Autism has multiple possible contributing factors, and its causes remain incompletely understood.
“As advantageous as electronic health records have proven to be for large-scale observational studies, these metrics still require healthcare access.”
— Aisha Dickerson, PhD, MSPH, in an accompanying editorial
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Limits of Records and Follow-Up
The study does not establish that any maternal condition causes autism, nor does it explain why the four reported associations were stronger among white mothers. The researchers and editorialist raised possible roles for access to healthcare and diagnostic differences, but those explanations were not confirmed by the analysis. Other unmeasured factors may also contribute.
The study relied on health system records, so diagnoses could be missed among people with limited access to care or whose conditions were not recorded. Follow-up was also finite and may not have captured autism diagnoses made at older ages. The results come from one health system and a defined group of children, so their applicability to other populations is uncertain. The researchers noted that race and ethnicity are only some of the dimensions that may affect these patterns.
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Further Research on Unequal Associations
The study does not announce a clinical change or a specific next step for families. Further research will be needed to test whether the observed differences hold in other populations and to examine possible influences such as insurance coverage, access to prenatal care and diagnostic practices. Longer follow-up could also capture diagnoses made after the study’s observation period.
For now, the findings support continued examination of how maternal health conditions are identified and documented across communities. They should not be read as proof that a mother’s health condition caused a child’s autism diagnosis.
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Key Questions
Did the study find that maternal health conditions cause autism?
No. It found associations in health records, which cannot establish that a condition caused an autism diagnosis.
Which maternal conditions showed differences across groups?
The reported differences involved overweight or obesity, depression, asthma and pregnancy complications. Their associations with autism were stronger among white mothers than among Black, Hispanic, and Asian and Pacific Islander mothers.
How large was the study?
Researchers examined 224,353 children born from 2010 to 2017 in the Kaiser Permanente Northern California health system. A total of 5,448 had an autism diagnosis recorded in the study.
Why might associations differ by race and ethnicity?
The study did not determine the reason. The authors and an accompanying editorial raised possible roles for healthcare access, diagnosis and unmeasured factors, but these explanations remain unconfirmed.
What are the main limitations?
The research relied on health records, which depend on access to care and recorded diagnoses. Its follow-up period may have missed diagnoses made at older ages, and the study does not show whether the findings apply to other populations.
Source: rss
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