Symptom severity in autism spectrum disorder is related to the frequency and severity of nausea and vomiting during pregnancy: a retrospective case-control study

Whitehouse, Andrew J. O.; Alvares, Gail A.; Cleary, Dominique; Harun, Alexis; Stojanoska, Angela; Taylor, Lauren; Varcin, Kandice J.; Maybery, Murray T.

doi:10.1186/s13229-018-0223-7

Cited by 10 publications

(7 citation statements)

References 62 publications

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“…Previous studies on the association of exposure to severe prolonged NVP and the risk of adverse health outcomes in the offspring are scarce. Two are mentioned in the introduction [ 10 , 11 ], and these much smaller studies ( n = 560 and 287, respectively) reported some changes in cognition and emotional and behavioral problems. The present study was much more powerful than previous studies, with a very large sample ( n = 10,710) demonstrating that a wide range of psychiatric (Table S2) and cognitive measures (Table S2) are associated with severe prolonged NVP and with external-validation of the major psychiatric findings in an independent national sample ( n = 2,092,897, Table 3 ).…”

Section: Discussionmentioning

confidence: 99%

“…These conditions play a crucial role in shaping fetal development and subsequent child brain and behavior development [ 6 – 9 ]. One study reported that severe prolonged NVP was associated with increased internalizing and externalizing behaviors in the offspring which reflect mood changes and conflict with others [ 10 ] and another reported decreased social responsiveness [ 11 ], highlighting the need for a large-scale evaluation of the long-term effects of exposure to severe prolonged NVP. As observed in two recent studies, clinical diagnosis of maternal hyperemesis gravidarum was associated with an increased risk of autism spectrum disorders in the offspring [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

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Severe nausea and vomiting in pregnancy: psychiatric and cognitive problems and brain structure in children

Wang

Rolls

et al. 2020

BMC Med

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Background: Two studies have suggested that severe prolonged nausea and vomiting during pregnancy is associated with emotional and behavioral problems in offspring, with smaller sample size and short-term follow-up. Moreover, little information is available on the role of the brain structure in the associations. Methods: In a US-based cohort, the association was investigated between severe prolonged nausea and vomiting in pregnancy (extending after the second trimester and termed SNVP), psychiatric and cognitive problems, and brain morphology, from the Adolescent Brain Cognitive Development (ABCD) study, from 10,710 children aged 9-11 years. We validated the emotional including psychiatric findings using the Danish National Cohort Study with 2,092,897 participants. Results: SNVP was significantly associated with emotional and psychiatric problems (t = 8.89, Cohen's d = 0.172, p = 6.9 × 10 −19) and reduced global cognitive performance (t = − 4.34, d = − 0.085, p = 1.4 × 10 −5) in children. SNVP was associated with low cortical area and volume, especially in the cingulate cortex, precuneus, and superior medial prefrontal cortex. These lower cortical areas and volumes significantly mediated the relation between SNVP and the psychiatric and cognitive problems in children. In the Danish National Cohort, severe nausea and vomiting in pregnancy were significantly associated with increased risks of behavioral and emotional disorders in children (hazard ratio, 1.24; 95% confidence interval, 1.16-1.33). Conclusions: SNVP is strongly associated with psychiatric and cognitive problems in children, with mediation by brain structure. These associations highlight the clinical importance and potential benefits of the treatment of SNVP, which could reduce the risk of psychiatric disorder in the next generation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Severe nausea and vomiting in pregnancy: psychiatric and cognitive problems and brain structure in children

Wang

Rolls

et al. 2020

BMC Med

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“…One such factor is increased maternal weight which has been linked to higher levels of prenatal testosterone 35 and to autistic traits 36 . Future research could also consider the potential etiological influence of nausea and vomiting during pregnancy which has been found to be related to increased symptom severity in ASD 37 . Maternal nausea and vomiting during pregnancy is thought to involve the dysregulation of several hormones including estrogens 38 which may have feminising properties.…”

Section: Discussionmentioning

confidence: 99%

A broad autism phenotype expressed in facial morphology

et al. 2020

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Autism spectrum disorder is a heritable neurodevelopmental condition diagnosed based on social and communication differences. There is strong evidence that cognitive and behavioural changes associated with clinical autism aggregate with biological relatives but in milder form, commonly referred to as the 'broad autism phenotype'. The present study builds on our previous findings of increased facial masculinity in autistic children (Sci. Rep., 7:9348, 2017) by examining whether facial masculinity represents as a broad autism phenotype in 55 non-autistic siblings (25 girls) of autistic children. Using 3D facial photogrammetry and age-matched control groups of children without a family history of ASD, we found that facial features of male siblings were more masculine than those of male controls (n = 69; p < 0.001, d = 0.81 [0.36, 1.26]). Facial features of female siblings were also more masculine than the features of female controls (n = 60; p = 0.005, d = 0.63 [0.16, 1.10]). Overall, we demonstrated for males and females that facial masculinity in non-autistic siblings is increased compared to same-sex comparison groups. These data provide the first evidence for a broad autism phenotype expressed in a physical characteristic, which has wider implications for our understanding of the interplay between physical and cognitive development in humans.

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“…In cases of clinically diagnosed autism, both very low and very high levels of hCG have been found in maternal serum, leading to a "U-shaped" association when studying both males and females (42). Furthermore, autistic traits in the children have been associated with the severity of nausea and 'morning sickness' during pregnancy, symptoms that are also linked to high hCG levels (43,44).…”

Section: Association Of Hormones With Infant Q-chat Scorementioning

confidence: 99%

Maternal Steroid Levels and the Autistic Traits of the Mother and Infant

Tsompanidis

Aydin

Padaigaitė

et al. 2021

Preprint

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Background: Elevated prenatal sex steroids and maternal conditions that are related to sex steroids (e.g., polycystic ovary syndrome) have been positively associated with autism likelihood. It is unclear if this is detectable in the maternal circulation, if it relates to maternal autistic traits, and whether it is also predictive of autistic traits in infants. Methods: Maternal serum samples were collected as part of routine prenatal screening from pregnant women taking part in the longitudinal Cambridge Ultrasound Siblings and Parents (CUSP) study (n=219) (gestational age: mean=12.7 [SD=0.8] weeks). Concentrations of the following were measured via immunoassays: testosterone (T), estradiol (E2), dehydroepiandrosterone sulphate (DHEAS), progesterone (P); sex hormone-binding globulin (SHBG). Human choriogonadotropin (hCG) and pregnancy-associated plasma protein A (PAPP-A) were collected from clinical records corresponding to the same serum samples. Participants completed the adult Autism Spectrum Quotient (AQ). Infants were followed-up with the Quantitative Checklist for Autism in Toddlers (Q-CHAT) between 18-20 months old (mean=570 days, SD=21.3 days). Results: Maternal AQ scores significantly correlated with circulating levels of total E2 (Pearson’s r=0.20, p=0.036) and the bioactive fraction of E2 (Pearson’s r=0.26, p=0.008) in univariate and multiple regression models. Total E2, DHEAS and a steroidogenic factor (derived from total E2, DHEAS and T) were all associated with Q-CHAT scores in multiple regression models that controlled for covariates and for an interaction with infant sex. This interaction also had a significant effect, leading to a positive correlation between hormone levels and Q-CHAT scores in males but not in females (interaction term: semipartial correlation r=0.23, p=0.018). The opposite was found for standardised hCG values and Q-CHAT scores, with a positive association in females but not in males (interaction term: semipartial correlation r=-0.22, p=0.009). Limitations: This longitudinal clinical study was relatively small and statistical power was further reduced by the need to account for different effects according to sex. The findings will need to be confirmed in a larger cohort and with clinically diagnosed cases of autism. Conclusion: In line with previous findings, this study’s results suggest that increased steroid synthesis prenatally is related to autistic traits and that this is detectable in the maternal circulation.

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Symptom severity in autism spectrum disorder is related to the frequency and severity of nausea and vomiting during pregnancy: a retrospective case-control study

Cited by 10 publications

References 62 publications

Severe nausea and vomiting in pregnancy: psychiatric and cognitive problems and brain structure in children

Severe nausea and vomiting in pregnancy: psychiatric and cognitive problems and brain structure in children

A broad autism phenotype expressed in facial morphology

Maternal Steroid Levels and the Autistic Traits of the Mother and Infant

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