Maternal prepregnancy weight and gestational weight gain in association with autism and developmental disorders in offspring

• Published in: Obesity (Silver Spring, Md.) Vol. 29; no. 9; p. 1554
• Main Authors: Matias, Susana L, Pearl, Michelle, Lyall, Kristen, Croen, Lisa A, Kral, Tanja V E, Fallin, Daniele, Lee, Li-Ching, Bradley, Chyrise B, Schieve, Laura A, Windham, Gayle C
• Format: Journal Article
• Language: English
• Published: United States 01.09.2021
• Subjects: Autism Spectrum Disorder - epidemiology; Autistic Disorder; Body Mass Index; Case-Control Studies; Child; Developmental Disabilities; Female; Gestational Weight Gain; Humans; Male; Overweight - epidemiology; Pregnancy; Weight Gain
• DOI: 10.1002/oby.23228

Maternal prepregnancy BMI and gestational weight gain (GWG) are examined in relation to autism spectrum disorder (ASD) and other developmental disorders (DD) in offspring in a multisite case-control study. Maternal prepregnancy BMI, obtained from medical records or self-report, was categorized as underweight, normal weight, overweight, obesity Class 1, or obesity Class 2/3. GWG was standardized for gestational age (GWG z score), and the rate (pounds/week) was categorized per adherence with clinical recommendations. Logistic regression models, adjusting for demographic factors, were used to assess associations with ASD (n = 1,159) and DD (n = 1,617), versus control children (n = 1,633). Maternal obesity Class 2/3 was associated with ASD (adjusted odds ratio [AOR] = 1.87, 95% CI: 1.40-2.51) and DD (AOR = 1.61, 95% CI: 1.22-2.13). GWG z score was not associated with DD (AOR = 1.14, 95% CI: 0.95-1.36), but the GWG z score highest tertile was associated with higher odds of ASD, particularly among male children (AOR = 1.47, 95% CI: 1.15-1.88). Results indicate that maternal prepregnancy severe obesity increases risk of ASD and DD in children and suggest high gestational-age-adjusted GWG is a risk factor for ASD in male children. Because maternal BMI and GWG are routinely measured and potentially modifiable, these findings could inform early interventions for high-risk mother-child dyads.