PTOTSLPCohortAutism research : official journal of the International Society for Autism Research2022

Association of maternal autoimmune disease and early childhood infections with offspring autism spectrum disorder: A population-based cohort study.

Timothy C Nielsen, Natasha Nassar, Antonia W Shand and 6 others

PMID 36189896

WHAT IT FOUND

Children with mothers who had autoimmune disease or who were hospitalized for infections before age two had higher odds of autism diagnosis by age nine.

However, having both exposures did not multiply the risk beyond what each contributes alone.

Key findings

01Exposure to any maternal autoimmune disease was associated with increased odds of autism spectrum disorder in the child by age 9 years.

02Hospitalization for any early childhood infection was associated with increased odds of autism spectrum disorder, with three or more infections carrying more than twice the odds.

03There was no evidence of a synergistic effect between maternal autoimmune disease and early childhood infections on the risk of autism.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs

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What it does not show

Exposure definitions relied on hospital admission codes, which likely missed autoimmune conditions managed in outpatient settings and infections that did not require hospitalization. The study cannot determine causality or direction; children with autism may be more susceptible to infections due to underlying immune differences, rather than infections causing autism. The analysis was limited to severe infections requiring hospitalization, so it does not account for the impact of common, mild childhood illnesses managed in primary care. The study did not capture all individuals with autism, particularly those who do not access publicly funded disability services.

Declared interests

The study was supported by non-U.S. government funding. No specific commercial conflicts of interest were declared in the provided text.

The easy way to misread this

Do not assume that preventing childhood infections or treating maternal autoimmune disease will reduce autism risk. This is an observational study showing association, not causation, and the direction of the relationship is uncertain.

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