A Phenotype of Childhood Autism Is Associated with Preexisting Maternal Anxiety and Depression
This study explored whether ASD phenotypes in the child were associated with a history of anxiety or depression in the mother. We hypothesized that an ASD profile in children characterized by mild delays and increased rates of dysregulation would be associated with preexisting maternal anxiety or depression. Participants were 672 preschool children with ASD and their mothers. Children were classified as ASD after a comprehensive developmental evaluation. Mothers reported whether a healthcare provider ever diagnosed them with anxiety or depression before the birth of their child. Four child ASD phenotypes were derived from latent class analysis: Mild Language Delay with Cognitive Rigidity (Type 1), Significant Developmental Delay with Repetitive Motor Behaviors (Type 2), General Developmental Delay (Type 3), and Mild Language and Motor Delay with Dysregulation (i.e., aggression, anxiety, depression, emotional reactivity, inattention, somatic complaints, and sleep problems) (Type 4). Type 2 ASD served as the referent category in statistical analyses. Results showed that 22.6% of mothers reported a diagnosis of anxiety or depression before the birth of their child. Maternal anxiety or depression was associated with 2.7 times the odds (95% confidence interval: 1.4, 5.3) of Type 4 or Dysregulated ASD in the child; maternal anxiety and depression was associated with 4.4 times the odds (95% confidence interval: 1.4, 14.0) of Type 4 or Dysregulated ASD in the child. Our findings suggest an association between Dysregulated ASD in the child and anxiety and depression in the mother. These findings can enhance screening methods and inform future research efforts.
KeywordsAutism Phenotype Maternal Anxiety Depression
The investigators acknowledge the contributions made to this study by project staff and enrolled families. Other author contributions were as follows: study concept (Lisa Wiggins), study design and methods (all authors), statistical plan (Eric Rubenstein, Lisa Wiggins, and Lin Tian), statistical analysis (Eric Rubenstein, Lin Tian, and Katherine Sabourin), statistical review and interpretation (all authors), manuscript preparation and/or review (all authors). This publication was supported by six cooperative agreements from the Centers for Disease Control and Prevention (CDC): Cooperative Agreement Number U10DD000180, Colorado Department of Public Health; Cooperative Agreement Number U10DD000181, Kaiser Foundation Research Institute (CA); Cooperative Agreement Number U10DD000182, University of Pennsylvania; Cooperative Agreement Number U10DD000183, Johns Hopkins University; Cooperative Agreement Number U10DD000184, University of North Carolina at Chapel Hill; and Cooperative Agreement Number U10DD000498, Michigan State University and the Health Services and Resources Administration (HRSA) Maternal Child Health Bureau, Leadership Education in Neurodevelopmental Disabilities (LEND) Grant Award #T73MC11044. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC.
Compliance with Ethical Standards
Conflict of Interest
There are no conflicts of interest to report.
This research was reviewed and approved by Institutional Review Boards at the Centers for Disease Control and Prevention (CDC) and each study site.
Informed consent was obtained by all families that participated in the study.
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