Prenatal and perinatal risk factors and the clinical implications on autism spectrum disorder.
Six common pregnancy complications forecast more hand-flapping and poorer social skills in children already diagnosed with autism.
01Research in Context
What this study did
Chien et al. (2019) looked at pregnancy and birth records of children with autism. They compared each autistic child to a brother or sister without autism. This sibling control keeps family genes and home life nearly the same.
The team counted six prenatal events: preeclampsia, gestational diabetes, early water break, placenta problems, slow growth, and baby heart-rate drops. They then scored how severe each child’s repetitive movements and social-communication delays were.
What they found
Kids who had one or more of the six birth events showed more hand-flapping, rocking, and rigid routines. They also scored lower on social-communication tests.
In short, early medical trouble inside the womb predicted worse autism symptoms years later.
How this fits with other research
Gillberg et al. (1983) first noticed that autistic children had rougher births than typical kids. Yi-Ling’s 2019 study keeps the same link but uses sibling pairs, making the signal cleaner.
Taylor et al. (2017) found that mom’s stress during pregnancy also worsens autism traits. Both papers point to the same trimester window, just different kinds of stress—medical versus emotional.
Cryan et al. (1996) once reported no extra birth problems in autism. The newer, larger samples with tighter controls now overturn that old null result.
Why it matters
When you read an intake file, flag any noted preeclampsia, gestational diabetes, or fetal distress. These children may start therapy with stronger repetitive or social deficits. You can plan extra visual supports and early stereotypy-reduction programs from day one.
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02At a glance
03Original abstract
Prenatal and perinatal factors may increase the risk of autism spectrum disorder. However, little is known about whether unaffected siblings of probands with autism spectrum disorder also share the phenomenon and whether the prenatal/perinatal factors are related to the clinical severity of autistic symptoms. We compared the frequency of prenatal and perinatal factors among 323 probands with autism spectrum disorder (mean age ± standard deviation, 10.7 ± 3.5 years; males, 91.0%), 257 unaffected siblings (11.7 ± 4.5; 42.8%), and 1504 typically developing controls (8.9 ± 1.6 years; 53.1%); and investigated their effects on the severity of autistic symptoms. We found that probands with autism spectrum disorder and their unaffected siblings had more prenatal/perinatal events than typically developing controls with higher numbers of prenatal/perinatal factors in probands than in unaffected siblings. The prenatal/perinatal events were associated with greater stereotyped behaviors, social-emotional problems, socio-communication deficits, and overall severity. We also found that six prenatal/perinatal factors (i.e. preeclampsia, polyhydramnios, oligoamnios, placenta previa, umbilical cord knot, and gestational diabetes) were associated with the severity of autistic symptoms, particularly stereotyped behaviors and socio-communication deficits. Our findings suggest that prenatal and perinatal factors may potentially moderate the clinical expression of autism spectrum disorder. The underlying mechanism warrants further research.
Autism : the international journal of research and practice, 2019 · doi:10.1177/1362361318772813