The Association between Threatened Miscarriage and Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder in Offspring by Age 14 Years.
Daire Buckley, Ali S Khashan, Fergus P McCarthy and 2 others
PMID 38281274WHAT IT FOUND
In a UK birth cohort, threatened miscarriage in early pregnancy was linked to higher odds of a child being diagnosed with autism or ADHD by age 14.
The association held after adjusting for maternal age, smoking, income and other factors, but genetic confounding cannot be ruled out.
Key findings
01Threatened miscarriage was associated with a 54% increase in odds of an ASD diagnosis by age 14 in the fully adjusted model.
02Threatened miscarriage was associated with a 51% increase in odds of an ADHD diagnosis by age 14 in the fully adjusted model.
03The association was significant in male infants for both ASD and ADHD, but not statistically significant in female infants.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Diagnoses of ASD and ADHD were based solely on parental recall, not confirmed by gold-standard clinical assessments like ADOS or ADI-R. Exposure to threatened miscarriage was self-reported at 9 months postpartum and may be underestimated compared to clinical registry data. The study could not control for genetic factors or family history of ASD/ADHD, which have high heritability. There was substantial loss to follow-up from wave 1 to wave 6, which may introduce selection bias. Sensitivity analyses excluding other pregnancy complications showed the association was no longer statistically significant for ASD, suggesting the effect may be influenced by co-occurring obstetric issues.
Declared interests
The study was funded by University College Cork. No other conflicts of interest were declared in the provided text.
The easy way to misread this
Do not interpret the association as causation. The study relies on parental recall for both exposure and outcomes, and could not account for genetic confounding, which is a major cause of ASD and ADHD. The findings do not mean threatened miscarriage causes neurodevelopmental disorders, only that they co-occur more often than expected by chance in this population.