Infection and Fever in Pregnancy and Autism Spectrum Disorders: Findings from the Study to Explore Early Development.
Mid-pregnancy fever may double autism risk, so treat it quickly.
01Research in Context
What this study did
Pitchford et al. (2019) tracked moms through pregnancy and asked: does getting sick with fever raise autism odds?
They used the SEED study, a big U.S. sample of kids with autism, developmental delay, or typical growth.
Doctors compared who caught flu-like bugs in each trimester and who later got an ASD diagnosis.
What they found
Fever from infection in the second trimester doubled the chance the child would later be diagnosed with ASD.
The risk stayed after the team adjusted for mom’s age, income, and other illnesses.
How this fits with other research
Tioleco et al. (2021) pooled 36 studies and saw the same small bump in risk, so the new finding is not a one-off.
Lyall et al. (2012) showed gestational diabetes also raises odds, hinting that several mid-pregnancy hits matter.
Frédérique et al. (2018) found brain overgrowth starts around 22 weeks, the same window A et al. flag for fever—timing lines up.
Why it matters
You can’t change the past, but you can teach pediatricians and OB teams to treat fever fast when moms report it at 4–6 months pregnant. Quick acetaminophen and care may shave a small but real slice off later ASD caseloads.
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02At a glance
03Original abstract
Maternal infection and fever during pregnancy have been implicated in the etiology of autism spectrum disorder (ASD); however, studies have not been able to separate the effects of fever itself from the impact of a specific infectious organism on the developing brain. We utilized data from the Study to Explore Early Development (SEED), a case-control study among 2- to 5-year-old children born between 2003 and 2006 in the United States, to explore a possible association between maternal infection and fever during pregnancy and risk of ASD and other developmental disorders (DDs). Three groups of children were included: children with ASD (N = 606) and children with DDs (N = 856), ascertained from clinical and educational sources, and children from the general population (N = 796), randomly sampled from state birth records. Information about infection and fever during pregnancy was obtained from a telephone interview with the mother shortly after study enrollment and maternal prenatal and labor/delivery medical records. ASD and DD status was determined by an in-person standardized developmental assessment of the child at 3-5 years of age. After adjustment for covariates, maternal infection anytime during pregnancy was not associated with ASD or DDs. However, second trimester infection accompanied by fever elevated risk for ASD approximately twofold (aOR = 2.19, 95% confidence interval 1.14-4.23). These findings of an association between maternal infection with fever in the second trimester and increased risk of ASD in the offspring suggest that the inflammatory response to the infectious agent may be etiologically relevant. Autism Res 2019, 12: 1551-1561. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Using data from a large multisite study in the United States-the Study to Explore Early Development-we found that women who had an infection during the second trimester of pregnancy accompanied by a fever are more likely to have children with ASD. These findings suggest the possibility that only more severe infections accompanied by a robust inflammatory response increase the risk of ASD.
Autism research : official journal of the International Society for Autism Research, 2019 · doi:10.1186/1742-2094-11-113