Preeclampsia Associated with Autism Spectrum Disorder
the MPR take:
An association between preeclampsia and autism-spectrum disorder and developmental delay has been identified in a new JAMA Pediatrics study, particularly with severe preeclampsia and/or placental insufficiency and developmental delay (DD). The population-based, case-controlled Childhood Autism Risks from Genetics and the Environment (CHARGE) study evaluated children ages 24–60 months from January 2003 to April 2011 based on three categories: children with ASD, children with DD without ASD, and children with typical development (TD). Self-reported data from 1,002 mothers on preeclampsia or toxemia during pregnancy was collected, along with medical records for 77.6% of the mothers surveyed. Preeclampsia complicated the gestations of children with ASD at more than twice the rate of children with TD; mothers of children with ASD and DD were significantly more likely to have had placental insufficiency, severe preeclampsia, or both compared with mothers of children with TD. Women with preeclampsia had more than twice the risk of having a child with ASD vs. women without the condition; risk of DD was substantially greater when placental compromise was identified. In particular, substantial ASD and DD risk was identified among mothers with severe preeclampsia. The authors posit that obesity and other maternal metabolic conditions that have been linked to preeclampsia and ASD in multiple populations may be factors in this relationship, although these results do not establish causality.
Increasing evidence suggests that autism spectrum disorder (ASD) and many forms of developmental delay (DD) originate during fetal development. Preeclampsia may trigger aberrant neurodevelopment through placental, maternal, and fetal physiologic mechanisms.