Abstract
Objectives
To examine associations between pregnancy planning and autism spectrum disorder (ASD) in offspring.
Methods
The Study to Explore Early Development (SEED), a multi-site case-control study, enrolled preschool-aged children with ASD, other DDs, and from the general population (POP). Some children with DDs had ASD symptoms but did not meet the ASD case definition. We examined associations between mother’s report of trying to get pregnant (pregnancy planning) and (1) ASD and (2) ASD symptomatology (ASD group, plus DD with ASD symptoms group combined) (each vs. POP group). We computed odds ratios adjusted for demographic, maternal, health, and perinatal health factors (aORs) via logistic regression. Due to differential associations by race-ethnicity, final analyses were stratified by race-ethnicity.
Results
Pregnancy planning was reported by 66.4%, 64.8%, and 76.6% of non-Hispanic White (NHW) mothers in the ASD, ASD symptomatology, and POP groups, respectively. Among NHW mother-child pairs, pregnancy planning was inversely associated with ASD (aOR = 0.71 [95% confidence interval 0.56–0.91]) and ASD symptomatology (aOR = 0.67 [0.54–0.84]). Pregnancy planning was much less common among non-Hispanic Black mothers (28-32% depending on study group) and Hispanic mothers (49-56%) and was not associated with ASD or ASD symptomatology in these two race-ethnicity groups.
Conclusion
Pregnancy planning was inversely associated with ASD and ASD symptomatology in NHW mother-child pairs. The findings were not explained by several adverse maternal or perinatal health factors. The associations observed in NHW mother-child pairs did not extend to other race-ethnicity groups, for whom pregnancy planning was lower overall.
Significance
Almost half of all the pregnancies in the U.S. are unintended and unintended pregnancy has been associated with adverse birth outcomes.
AbstractSection What this Study adds?Among non-Hispanic white mother-child pairs, pregnancy planning was inversely associated with autism spectrum disorder (ASD) and ASD symptomatology. This association was not seen for non-Hispanic Black and Hispanic mother-child pairs, for whom pregnancy planning was lower overall.
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Data Availability
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Code Availability
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Acknowledgements
We thank other SEED collaborators and the SEED Data Coordinating Center team at the Clinical and Translational Sciences Institute of Michigan State University for their support throughout this study. This research was supported by 12 cooperative agreements from the Centers for Disease Control and Prevention: 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 (PA); Cooperative Agreement Number U10DD000183, Johns Hopkins University (MD); Cooperative Agreement Number U10DD000184, University of North Carolina at Chapel Hill (NC); Cooperative Agreement Number U10DD000498, Michigan State University (DCC); Cooperative Agreement Number U01000750, University of Colorado Denver; Cooperative Agreement Number U01000748, Kaiser Foundation Research Institute (CA); Cooperative Agreement Number U01000752, University of Pennsylvania; Cooperative Agreement Number U01000746, Johns Hopkins University; Cooperative Agreement Number U01000749, University of North Carolina at Chapel Hill; and Cooperative Agreement Number U10DD000901, Michigan State University.
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Harris, S.T., Schieve, L.A., Drews-Botsch, C. et al. Pregnancy Planning and its Association with Autism Spectrum Disorder: Findings from the Study to Explore Early Development. Matern Child Health J 28, 949–958 (2024). https://doi.org/10.1007/s10995-023-03877-0
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DOI: https://doi.org/10.1007/s10995-023-03877-0