Journal of Autism and Developmental Disorders

, Volume 49, Issue 11, pp 4572–4583 | Cite as

Early Second Trimester Maternal Serum Steroid-Related Biomarkers Associated with Autism Spectrum Disorder

  • Deborah A. BilderEmail author
  • M. Sean Esplin
  • Hilary Coon
  • Paul Burghardt
  • Erin A. S. Clark
  • Alison Fraser
  • Ken R. Smith
  • Whitney Worsham
  • Katlin Chappelle
  • Thomas Rayner
  • Amanda V. Bakian
Origina lPaper


Epidemiologic studies link increased autism spectrum disorder (ASD) risk to obstetrical conditions associated with inflammation and steroid dysregulation, referred to as prenatal metabolic syndrome (PNMS). This pilot study measured steroid-related biomarkers in early second trimester maternal serum collected during the first and second trimester evaluation of risk study. ASD case and PNMS exposure status of index offspring were determined through linkage with autism registries and birth certificate records. ASD case (N = 53) and control (N = 19) groups were enriched for PNMS exposure. Higher estradiol and lower sex hormone binding globulin (SHBG) were significantly associated with increased ASD risk. Study findings provide preliminary evidence to link greater placental estradiol activity with ASD and support future investigations of the prenatal steroid environment in ASD.


Autism Biomarkers Prenatal risk factors Metabolic syndrome 



We thank the Utah FASTER study participants whose contributions were essential for the success of this study. We appreciate the unique collaboration provided across the University of Utah, Intermountain Healthcare, Utah Registry of Autism and Developmental Disabilities, Utah Department of Health, Utah State Board of Education, and the Pedigree and Population Resource (funded by the Huntsman and Intermountain Healthcare Cancer Foundation).

Author Contributions

DBA and AVB designed and performed the research, analyzed data, and wrote the manuscript with input from other authors. MSE, EASC, KRS and AF designed and performed the research. PB and KC designed and performed the research and completed serum analyses. HC designed and performed the research and analyzed the data. TR and WW designed and performed the research and wrote the manuscript with input from the other authors.

Compliance with Ethical Standards

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Utah Registry of Autism and Developmental Disabilities Oversight Committee, Utah State Office of Education, and the Institutional Review Boards of the University of Utah, Intermountain Healthcare, Utah Department of Health, and Resource for Genetic and Epidemiologic Research Review Committee, which is an oversight body that regulates Utah Population Database access and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Supplementary material

10803_2019_4162_MOESM1_ESM.docx (118 kb)
Supplementary material 1 (DOCX 118 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Deborah A. Bilder
    • 1
    • 5
    Email author
  • M. Sean Esplin
    • 1
    • 2
  • Hilary Coon
    • 1
  • Paul Burghardt
    • 3
  • Erin A. S. Clark
    • 1
  • Alison Fraser
    • 1
    • 4
  • Ken R. Smith
    • 1
    • 4
  • Whitney Worsham
    • 1
  • Katlin Chappelle
    • 3
  • Thomas Rayner
    • 1
  • Amanda V. Bakian
    • 1
  1. 1.University of UtahSalt Lake CityUSA
  2. 2.Intermountain HealthcareSalt Lake CityUSA
  3. 3.Wayne State UniversityDetroitUSA
  4. 4.Huntsman Cancer InstituteSalt Lake CityUSA
  5. 5.Utah Autism Research ProgramUniversity of UtahSalt Lake CityUSA

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