Association between preeclampsia and autism spectrum disorder: a population-based study

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dc.contributor.author Maher, Gillian M.
dc.contributor.author O'Keeffe, Gerard W.
dc.contributor.author Dalman, Christina
dc.contributor.author Kearney, Patricia M.
dc.contributor.author McCarthy, Fergus P.
dc.contributor.author Kenny, Louise C.
dc.contributor.author Khashan, Ali S.
dc.date.accessioned 2019-11-12T15:05:39Z
dc.date.available 2019-11-12T15:05:39Z
dc.date.issued 2019-09-17
dc.identifier.citation Maher, G. M., O'Keeffe, G. W., Dalman, C., Kearney, P. M., McCarthy, F. P., Kenny, L. C. and Khashan, A. S. (2019) 'Association between preeclampsia and autism spectrum disorder: a population-based study', Journal of Child Psychology and Psychiatry. doi: 10.1111/jcpp.13127 en
dc.identifier.issn 0021-9630
dc.identifier.uri http://hdl.handle.net/10468/8992
dc.identifier.doi 10.1111/jcpp.13127 en
dc.description.abstract Background: The environmental contribution of autism spectrum disorder (ASD) is approximately 17%–50%, highlighting the importance of investigating factors potentially contributing to the likelihood of its development, and of gaining a greater understanding of the pathogenesis surrounding ASD. The objective of this study was to examine the association between preeclampsia and ASD using a population‐based cohort study. Methods: All singleton live births in Sweden from 1982 to 2010 were included, using data from Swedish National Registers. Exposures of interest included: (a) preeclampsia (classified according to ICD‐8, ICD‐9 and ICD‐10) and (b) preeclampsia and small for gestational age (SGA) combined, used as a proxy for preeclampsia with placental dysfunction. ASD status was based on ICD‐9 and ICD‐10. The cohort consisted of 2,842,230 children, with 54,071 cases of ASD. Follow‐up began from the child's first birthday, and data were censored at first diagnosis of ASD, death, migration or end of study period (31st December 2016). We conducted multivariate Cox proportional hazards regression analysis, adjusting for several perinatal and sociodemographic factors, selected a priori. We further controlled for shared genetic and familial confounding using sibling‐matched analysis. Results: In the adjusted Cox proportional hazards regression analysis, preeclampsia was associated with a 25% increase in the likelihood of ASD (Hazard Ratio (HR): 1.25, 95% CI:1.19, 1.30) compared with those unexposed to preeclampsia, while in the sibling‐matched analysis the HR was 1.17 (95% CI: 1.06, 1.28). The HR for preeclampsia and SGA combined was 1.66 (95% CI: 1.49, 1.85) in the adjusted Cox model and 1.95 (95% CI: 1.53, 2.48) in the sibling‐matched analysis. Conclusions: Exposure to preeclampsia or preeclampsia/SGA (i.e. SGA baby exposed to preeclampsia) was associated with ASD. The stronger association with preeclampsia/SGA than preeclampsia alone suggests that placental pathology may be a mechanism for the increased likelihood of ASD. en
dc.description.sponsorship Health Research Board (Grant Number: SPHeRE/2013/1) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher John Wiley & Sons Ltd. en
dc.relation.uri https://onlinelibrary.wiley.com/doi/abs/10.1111/jcpp.13127
dc.rights © 2019, Association for Child and Adolescent Mental Health. Published by John Wiley & Sons Ltd. This is the peer reviewed version of the following article: Maher, G. M., O'Keeffe, G. W., Dalman, C., Kearney, P. M., McCarthy, F. P., Kenny, L. C. and Khashan, A. S. (2019) 'Association between preeclampsia and autism spectrum disorder: a population-based study', Journal of Child Psychology and Psychiatry, doi: 10.1111/jcpp.13127, which has been published in final form at https://doi.org/10.1111/jcpp.13127. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. en
dc.subject Autism spectrum disorder en
dc.subject Preeclampsia en
dc.subject Epidemiology en
dc.title Association between preeclampsia and autism spectrum disorder: a population-based study en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Gillian Maher, Public Health, University College Cork, Cork, Ireland. +353-21-490-3000 Email: gillian.maher@ucc.ie en
dc.internal.availability Full text available en
dc.check.info Access to this article is restricted until 12 months after publication by request of the publisher. en
dc.check.date 2020-09-17
dc.date.updated 2019-11-12T14:53:48Z
dc.description.version Accepted Version en
dc.internal.rssid 499912312
dc.contributor.funder Health Research Board en
dc.contributor.funder Science Foundation Ireland en
dc.description.status Peer reviewed en
dc.identifier.journaltitle Journal of Child Psychology and Psychiatry en
dc.internal.copyrightchecked Yes
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress gillian.maher@ucc.ie en
dc.internal.bibliocheck In press. Check vol / issue / page range. Amend citation and copyright statement as necessary. en
dc.relation.project info:eu-repo/grantAgreement/SFI/SFI Research Centres/12/RC/2272/IE/Irish Centre for Fetal and Neonatal Translational Research (INFANT)/ en
dc.identifier.eissn 1469-7610


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