Infection and Fever in Pregnancy and Autism Spectrum Disorders: Findings from the Study to Explore Early Development.
Lisa A Croen, Yinge Qian, Paul Ashwood and 9 others
PMID 31317667WHAT IT FOUND
Overall maternal infection in pregnancy was not linked to higher autism risk.
A link appeared for fever with infection in the second trimester, but it weakened when medication treatment was considered. This is an observational risk study, not treatment guidance.
Key findings
01Maternal infection at any point during pregnancy was not associated with higher risk of ASD.
02Maternal infection with fever in the second trimester was reported as associated with higher ASD risk, but adjustment for medication treatment made the association no longer statistically significant.
03Maternal infection in the 3 months before conception was associated with higher ASD risk, and this was seen only in children with ASD and intellectual disability.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The paper did not have data on the number, duration, or intensity of fevers, or on the severity of infections. Some specific infections were too rare to analyze in detail. Infection and fever were partly based on caregiver recall after the child was 2 to 5 years old, although medical records were also used. Some analyses had small counts, so findings could be due to chance or factors not measured. The study did not examine behavioral or psychiatric subtypes such as ADHD. Families who did not respond may differ from those enrolled, and the enrolled sample had sociodemographic differences between groups. The study adjusted for maternal age, education, and race or ethnicity, but the authors note other unmeasured factors may remain.
Declared interests
The supplied text says the authors report no competing interests. The metadata lists non-U.S. government and U.S. Public Health Service research support, but no funder role is stated.
The easy way to misread this
Do not read this as proof that fever in pregnancy causes autism or that treating fever prevents it. The second-trimester fever association was not statistically significant after medication adjustment, and the study was a case-control analysis, not a treatment trial.