Interpregnancy Interval and Risk of Autism Spectrum Disorders

Zerbo, Ousseny; Yoshida, Cathleen K.; Gunderson, Erica P.; Dorward, Kaht; Croen, Lisa

doi:10.1542/peds.2015-1099

Cited by 43 publications

(57 citation statements)

References 38 publications

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“…32 However, a sensitivity analysis restricted to individuals with more severe ASD revealed a significant association between IPIs of <12 months and this disorder. Three studies also found a significant association between ASD and long IPIs (≥60 months, 31 ≥72 months, 34 and ≥84 months 33 ). Five studies reported a significantly increased risk of the former subtype autistic disorder associated with short IPIs.…”

Section: Autism Spectrum Disordermentioning

confidence: 90%

“…28,31,33 However, long IPIs were found to be associated with an increased risk of the former subtypes Asperger disorder and PDD-NOS in 3 studies. 31,33,34 Overall, there was no association between short IPIs and the risk of these 2 disorders. 30,31,33,34 Table 2 shows the meta-analyses of the association between IPI and ASD.…”

Section: Autism Spectrum Disordermentioning

confidence: 92%

“…Five studies reported a significantly increased risk of the former subtype autistic disorder associated with short IPIs. 28,30,31,33,34 No relationship was found between long IPIs and this disorder in 3 studies. 28,31,33 However, long IPIs were found to be associated with an increased risk of the former subtypes Asperger disorder and PDD-NOS in 3 studies.…”

Section: Autism Spectrum Disordermentioning

confidence: 92%

“…A total of 12 studies (6 cohort, 5 cross-sectional, and 1 case-control), including 1 334 569 children, met the inclusion criteria. [28][29][30][31][32][33][34][35][36][37][38][39] The individual characteristics and main findings of the studies included in the systematic review are shown in Table 1. Seven studies provided data on ASD, 28 …”

Section: Data Synthesis and Statistical Analysismentioning

confidence: 99%

“…[28][29][30][31][32][33][34] Three studies showed a U-shaped association between IPI and the risk of ASD. 31,33,34 Six studies found a significant association between short IPIs (<12 months, 30,31,33 <18 months, 29 <24 months, 34 and <36 months 28 ) and increased risk of ASD. The remaining study reported a nonsignificant greater risk of ASD among children born after an IPI of <12 months (adjusted OR 1.72, 95% CI 0.96-3.06).…”

Section: Autism Spectrum Disordermentioning

confidence: 99%

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Birth Spacing and Risk of Autism and Other Neurodevelopmental Disabilities: A Systematic Review

2016

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Section: Autism Spectrum Disordermentioning

confidence: 90%

Section: Autism Spectrum Disordermentioning

confidence: 92%

Section: Autism Spectrum Disordermentioning

confidence: 92%

Section: Data Synthesis and Statistical Analysismentioning

confidence: 99%

Section: Autism Spectrum Disordermentioning

confidence: 99%

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Birth Spacing and Risk of Autism and Other Neurodevelopmental Disabilities: A Systematic Review

2016

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Autism Spectrum Disorder

Hirota

King

2023

JAMA

259

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ImportanceAutism spectrum disorder (ASD), characterized by deficits in social communication and the presence of restricted, repetitive behaviors or interests, is a neurodevelopmental disorder affecting approximately 2.3% children aged 8 years in the US and approximately 2.2% of adults. This review summarizes evidence on the diagnosis and treatment of ASD.ObservationsThe estimated prevalence of ASD has been increasing in the US, from 1.1% in 2008 to 2.3% in 2018, which is likely associated with changes in diagnostic criteria, improved performance of screening and diagnostic tools, and increased public awareness. No biomarkers specific to the diagnosis of ASD have been identified. Common early signs and symptoms of ASD in a child’s first 2 years of life include no response to name when called, no or limited use of gestures in communication, and lack of imaginative play. The criterion standard for the diagnosis of ASD is a comprehensive evaluation with a multidisciplinary team of clinicians and is based on semistructured direct observation of the child’s behavior and semistructured caregiver interview focused on the individual’s development and behaviors using standardized measures, such as the Autism Diagnostic Observation Schedule-Second Edition and the Autism Diagnostic Interview. These diagnostic measures have sensitivity of 91% and 80% and specificity of 76% and 72%, respectively. Compared with people without ASD, individuals with ASD have higher rates of depression (20% vs 7%), anxiety (11% vs 5%), sleep difficulties (13% vs 5%), and epilepsy (21% with co-occurring intellectual disability vs 0.8%). Intensive behavioral interventions, such as the Early Start Denver Model, are beneficial in children 5 years or younger for improvement in language, play, and social communication (small to medium effect size based on standardized mean difference). Pharmacotherapy is indicated for co-occurring psychiatric conditions, such as emotion dysregulation or attention-deficit/hyperactivity disorder. Risperidone and aripiprazole can improve irritability and aggression (standardized mean difference of 1.1, consistent with a large effect size) compared with placebo. Psychostimulants are effective for attention-deficit/hyperactivity disorder (standardized mean difference of 0.6, consistent with a moderate effect size) compared with placebo. These medications are associated with adverse effects including, most commonly, changes in appetite, weight, and sleep.Conclusions and RelevanceASD affects approximately 2.3% of children aged 8 years and approximately 2.2% of adults in the US. First-line therapy consists of behavioral interventions, while co-occurring psychiatric conditions, such as anxiety or aggression, may be treated with specific behavioral therapy or medication.

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Interpregnancy Interval After Healthy Live Birth and Subsequent Spontaneous Abortion

Hu,

Yang,

Wang

et al. 2024

JAMA Netw Open

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ImportanceMany studies have reported that the interpregnancy interval (IPI) is a potential modifiable risk factor for adverse perinatal outcomes. However, the association between IPI after live birth and subsequent spontaneous abortion (SA) is unclear.ObjectiveTo investigate the association of IPI after a healthy live birth and subsequent SA.Design, Setting, and ParticipantsThis prospective cohort study used data from 180 921 women aged 20 to 49 years who had a single healthy live birth and planned for another pregnancy and who participated in the Chinese National Free Prepregnancy Checkups Project from January 1, 2010, to December 31, 2020. Statistical analysis was conducted from June 20 to October 5, 2023.ExposureInterpregnancy interval, defined as the interval between the delivery date and conception of the subsequent pregnancy, was categorized as follows: less than 18 months, 18 to 23 months, 24 to 35 months, 36 to 59 months, and 60 months or longer.Main Outcomes and MeasuresThe main outcome was SA. Multivariable-adjusted odds ratios (ORs) were calculated by logistic regression models to examine the association between IPI and the risk of SA. Dose-response associations were evaluated by restricted cubic splines.ResultsThe analyses included 180 921 multiparous women (mean [SD] age at current pregnancy, 26.3 [2.8] years); 4380 SA events (2.4% of all participants) were recorded. A J-shaped association between IPI levels and SA was identified. In the fully adjusted model, compared with IPIs of 18 to 23 months, both short (&lt;18 months) and long (≥36 months) IPIs showed an increased risk of SA (IPIs of &lt;18 months: OR, 1.15 [95% CI, 1.04-1.27]; IPIs of 36-59 months: OR, 1.28 [95% CI, 1.15-1.43]; IPIs of ≥60 months: OR, 2.13 [95% CI, 1.78-2.56]). Results of the subgroup analysis by mode of previous delivery were consistent with the main analysis.Conclusions and RelevanceThis cohort study of multiparous women suggests that an IPI of shorter than 18 months or an IPI of 36 months or longer after a healthy live birth was associated with an increased risk of subsequent SA. The findings are valuable to make a rational prepregnancy plan and may facilitate the prevention of SA and improvement in neonatal outcomes.

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Interpregnancy Interval and Risk of Autism Spectrum Disorders

Cited by 43 publications

References 38 publications

Birth Spacing and Risk of Autism and Other Neurodevelopmental Disabilities: A Systematic Review

Birth Spacing and Risk of Autism and Other Neurodevelopmental Disabilities: A Systematic Review

Autism Spectrum Disorder

Interpregnancy Interval After Healthy Live Birth and Subsequent Spontaneous Abortion

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