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

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 fo...

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Published in:	Journal of psychiatric research 2014-07, Vol.54, p.100-108
Main Authors:	Froehlich-Santino, Wendy, Londono Tobon, Amalia, Cleveland, Sue, Torres, Andrea, Phillips, Jennifer, Cohen, Brianne, Torigoe, Tiffany, Miller, Janet, Fedele, Angie, Collins, Jack, Smith, Karen, Lotspeich, Linda, Croen, Lisa A, Ozonoff, Sally, Lajonchere, Clara, Grether, Judith K, O'Hara, Ruth, Hallmayer, Joachim
Format:	Article
Language:	eng
Subjects:	Age Factors Antenatal Autism Autistic spectrum disorders Biological and medical sciences Child clinical studies Child Development Disorders, Pervasive - epidemiology Child Development Disorders, Pervasive - genetics Developmental disorders Diseases in Twins - epidemiology Diseases in Twins - genetics Environment Female Gestational Age Humans Infantile autism Male Medical sciences Parents Perinatal Perinatal factors Pregnancy Pregnancy complications Prenatal Prenatal Exposure Delayed Effects - physiopathology Prospective Studies Psychiatry Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Respiratory disorders Risk Factors Statistics, Nonparametric Twins
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Summary:	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.
ISSN:	0022-3956 1879-1379