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