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J Psychiatr Res. 2014 Jul;54:100-8. doi: 10.1016/j.jpsychires.2014.03.019. Epub 2014 Mar 29.

Prenatal and perinatal risk factors in a twin study of autism spectrum disorders.

Author information

1
Department of Psychiatry, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: wendyf@stanford.edu.
2
Department of Psychiatry, Stanford University School of Medicine, Stanford, CA, USA.
3
Autism Genetic Resource Exchange, Autism Speaks, Los Angeles, CA, USA.
4
Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
5
Impact Assessment, Inc, La Jolla, CA, USA.
6
University of California, Davis, MIND Institute, Sacramento, CA, USA.
7
Environmental Health Investigations Branch, California Department of Public Health, Richmond, CA, USA.

Abstract

INTRODUCTION:

Multiple studies associate prenatal and perinatal complications with increased risks for autism spectrum disorders (ASDs). The objectives of this study were to utilize a twin study design to 1) Investigate whether shared gestational and perinatal factors increase concordance for ASDs in twins, 2) Determine whether individual neonatal factors are associated with the presence of ASDs in twins, and 3) Explore whether associated factors may influence males and females differently.

METHODS:

Data from medical records and parent response questionnaires from 194 twin pairs, in which at least one twin had an ASD, were analyzed.

RESULTS:

Shared factors including parental age, prenatal use of medications, uterine bleeding, and prematurity did not increase concordance risks for ASDs in twins. Among the individual factors, respiratory distress demonstrated the strongest association with increased risk for ASDs in the group as a whole (OR 2.11, 95% CI 1.27-3.51). Furthermore, respiratory distress (OR 2.29, 95% CI 1.12-4.67) and other markers of hypoxia (OR 1.99, 95% CI 1.04-3.80) were associated with increased risks for ASDs in males, while jaundice was associated with an increased risk for ASDs in females (OR 2.94, 95% CI 1.28-6.74).

CONCLUSIONS:

Perinatal factors associated with respiratory distress and other markers of hypoxia appear to increase risk for autism in a subgroup of twins. Future studies examining potential gender differences and additional prenatal, perinatal and postnatal environmental factors are required for elucidating the etiology of ASDs and suggesting new methods for treatment and prevention.

KEYWORDS:

Autism; Environment; Perinatal; Pregnancy complications; Prenatal; Twins

PMID:
24726638
PMCID:
PMC4072527
DOI:
10.1016/j.jpsychires.2014.03.019
[Indexed for MEDLINE]
Free PMC Article

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