Most prior studies examining maternal pre‐pregnancy body mass index (BMI) in relation to offspring autism spectrum disorders (ASD) have reported an association, though findings are not uniform and few have also examined gestational weight gain (GWG). Therefore, we examined both in the Study to Explore Early Development, a multi‐site case–control study of children born in 2003–2006. Children identified from clinics, schools, and birth certificates were enrolled at ages 2–5 year and using standardized developmental evaluations, classified as: ASD, other developmental delays (DD), or population‐based controls. Maternal height, weight, and GWG were self‐reported during the telephone interview. Three primary weight risk factors were examined: (a) Pre‐pregnancy BMI, classified as underweight to obese, (b) GWG continuous and categorized as quintiles, and (c) Institute of Medicine clinical weight‐gain recommendations. Odds ratios adjusted (AOR) for sociodemographic and prenatal factors were calculated among term singletons, comparing the ASD (n = 540) or DD (n = 720) groups to the control group (n = 776). The AOR of ASD and maternal obesity was 1.37 (95%CI 0.98–1.92). Associations with higher GWG were stronger (Quintile5 vs. Quintile3 AOR = 1.58, 95%CI 1.08–2.31), and particularly so among overweight/obese women (AOR = 1.90, 95%CI 0.98–3.68). DD was associated with maternal overweight and obesity (obesity AOR = 1.48, 95%CI 1.08–2.02), but not with total GWG or clinical recommendations. High maternal BMI and GWG are risk factors for other pregnancy and child outcomes, and our results suggest they may also represent modifiable risk factors for neurodevelopmental outcomes. Autism Res 2019, 12: 316–327 © 2018 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary In a large, national study, we found that children with autism were more likely than unaffected children to have mothers with higher weight gain during pregnancy; risk of autism may be even stronger if mothers were also overweight before pregnancy. Children with other developmental delays were more likely to have mothers who were overweight or obese before pregnancy, but not who gained more weight during pregnancy. Overweight and weight gain may represent factors that could be modified.

Background Research comparing the survival of children with familial dilated cardiomyopathy (FDCM) to that of children with idiopathic dilated cardiomyopathy (IDCM) has produced conflicting results. Methods and Results We analyzed data from children with FDCM or IDCM using the National Heart, Lung, and Blood Institute-funded Pediatric Cardiomyopathy Registry. Compared to children with IDCM (n=647), children with FDCM (n=223) were older (mean 6.2 vs. 4.5 years, P <0.001), less often had heart failure (64% vs. 78%, P <0.001), had less-depressed mean left ventricular (LV) fractional shortening z-scores (−7.85 ± 3.98 vs. −9.06 ± 3.89, P <0.001) and lower end-diastolic dimension z-scores (4.12 ± 2.61 vs. 4.91 ± 2.57, P <0.001) at diagnosis. The cumulative incidence of death was lower for patients with FDCM compared with IDCM (P=0.04; hazard ratio 0.64, P=0.06) but no difference in risk of transplant or the combined death or transplant outcome. There was no difference in the proportion of children with echocardiographic normalization at three years of follow-up (FDCM, 30% vs. IDCM, 26%; P=0.33). Multivariable analysis showed no difference in outcomes between FDCM and IDCM but for both groups older age, congestive heart failure (CHF) and increased LV end-systolic dimension z-score at diagnosis were independently associated with an increased risk of death or heart transplantation (all Ps <0.001). Conclusions There was no survival difference between FDCM and IDCM after adjustment for other factors. Older age, CHF, and greater LV dilation at diagnosis were independently associated with increased risk of the combined endpoint of death or transplantation. Clinical Trial Registration https://clinicaltrials.gov; NCT00005391

Background Prenatal alcohol exposure can affect neurodevelopment, but few studies have examined associations with autism spectrum disorder (ASD). Methods We assessed the association between maternal alcohol use and ASD in the Study to Explore Early Development, a multi-site case-control study of children born September 2003 – August 2006 in the U.S. Regression analyses included 684 children with research clinician-confirmed ASD, 869 children with non-ASD developmental delays or disorders (DDs) and 962 controls ascertained from the general population (POP). Maternal alcohol exposure during each month from three months prior to conception until delivery was assessed by self-report. Results Mothers of POP children were more likely to report any prenatal alcohol use than mothers of children with ASD or DD. In trimester one, 21.2% of mothers of POP children reported alcohol use compared to 18.1% and 18.2% of mothers of children with ASD or DD, respectively (adjusted OR for ASD versus POP 0.8, 95% confidence interval 0.6, 1.1). During preconception and the first month of pregnancy, 1–2 drinks on average per week was inversely associated with ASD risk. Conclusions These results do not support an adverse association between low-level alcohol exposure and ASD, though these findings were based retrospective self-reported alcohol use. Unmeasured confounding or exposure misclassification may explain inverse associations with 1–2 drinks per week. Pregnant or potentially pregnant women should continue to follow recommendations to avoid alcohol use because of other known effects on infant health and neurodevelopment.