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Brain Behav Immun. 2015 Feb;44:100-5. doi: 10.1016/j.bbi.2014.09.001. Epub 2014 Sep 16.

Maternal hospitalization with infection during pregnancy and risk of autism spectrum disorders.

Author information

1
Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, PA, USA; A.J. Drexel Autism Institute, Philadelphia, PA, USA. Electronic address: bklee@drexel.edu.
2
Division of Public Health Epidemiology, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
3
Division of Public Health Epidemiology, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden.
4
Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, PA, USA; A.J. Drexel Autism Institute, Philadelphia, PA, USA.
5
A.J. Drexel Autism Institute, Philadelphia, PA, USA; Department of Environmental and Occupational Health, Drexel University School of Public Health, Philadelphia, PA, USA.
6
Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden.

Abstract

Animal models indicate that maternal infection during pregnancy can result in behavioral abnormalities and neuropathologies in offspring. We examined the association between maternal inpatient diagnosis with infection during pregnancy and risk of ASD in a Swedish nationwide register-based birth cohort born 1984-2007 with follow-up through 2011. In total, the sample consisted of 2,371,403 persons with 24,414 ASD cases. Infection during pregnancy was defined from ICD codes. In the sample, 903 mothers of ASD cases (3.7%) had an inpatient diagnosis of infection during pregnancy. Logistic regression models adjusted for a number of covariates yielded odds ratios indicating approximately a 30% increase in ASD risk associated with any inpatient diagnosis of infection. Timing of infection did not appear to influence risk in the total Swedish population, since elevated risk of ASD was associated with infection in all trimesters. In a subsample analysis, infections were associated with greater risk of ASD with intellectual disability than for ASD without intellectual disability. The present study adds to the growing body of evidence, encompassing both animal and human studies, that supports possible immune-mediated mechanisms underlying the etiology of ASD.

KEYWORDS:

Autism; Cytokines; Epidemiology; Infection

PMID:
25218900
PMCID:
PMC4418173
DOI:
10.1016/j.bbi.2014.09.001
[Indexed for MEDLINE]
Free PMC Article

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