Associations of unintended pregnancy with autism spectrum disorders and the modification of folic acid supplements.
Unplanned pregnancy raised toddler autism screen scores, but folic acid nearly cancelled the extra risk.
01Research in Context
What this study did
Doctors tracked 1,510 Chinese toddlers from birth to 30 months old.
They asked moms if the pregnancy was planned and if they took folic acid pills.
Kids got an autism screen at 16-30 months using the M-CHAT.
What they found
Kids from surprise pregnancies had a large share higher odds of an autism red-flag score.
When moms skipped folic acid, the odds almost tripled.
Folic acid wiped out most of the extra risk from an unplanned pregnancy.
How this fits with other research
Tioleco et al. (2021) pooled 36 studies and found any prenatal infection also nudged autism odds up a little. Our new study points to a different, but still fixable, prenatal factor: missing folic acid.
Syriopoulou-Delli et al. (2012) saw no autism link with moms who smoked while pregnant once family income was counted. The fresh finding shows unplanned pregnancy carries risk even after money and schooling are held constant.
Adams et al. (2024) showed low thyroid hormone in pregnant mice caused autism-like behaviors, but giving thyroid hormone back prevented them. The pattern is the same: a simple nutrient supplement can block a prenatal stressor.
Why it matters
You can't change whether a pregnancy was planned, but you can ask about folic acid at your first parent interview. If mom didn't take it, flag the chart for closer developmental watch and offer a simple vitamin plan. Early action costs pennies and may shave off some of the extra autism risk carried by surprise pregnancies.
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02At a glance
03Original abstract
There is limited evidence on the associations of unintended pregnancy with autism spectrum disorders (ASD). This study aimed to examine this relationship and the modification of pre-conceptional and prenatal folic acid supplements. Six thousand and five toddlers aged 16 to 30 months from seven cities of six provinces in China were eligible for participation. Information on unintended pregnancy and folic acid supplements was obtained via questionnaires from caregivers of toddlers. The diagnosis of ASD was based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and the Chinese version of the Childhood Autism Rating Scale (CARS). Of the 6005 toddlers in the study (3337 boys and 2668 girls), 71 (1.18%) received the diagnosis of ASD. Generalized linear models with a logit link function showed unintended pregnancy was positively associated with ASD (odds ratios [OR] = 1.69, 95% confidence interval [CI], 1.05-2.79). Stratified estimates indicated that the association remained stable among toddlers of mothers without pre-conceptional and prenatal folic acid supplements (OR = 2.75, 95% CI, 1.04-7.27; n = 1243, 20.70%). Unintended pregnancy was associated with higher odds of ASD in 16-30 months of toddlers, and the association was consistent among toddlers of mothers without prenatal folic acid supplements. Our findings emphasize the need to raise awareness of the risk of unintended pregnancy and the benefits of folic acid supplements among Chinese women.
Autism research : official journal of the International Society for Autism Research, 2024 · doi:10.1002/aur.3070