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. 2024 May;28(5):949-958.
doi: 10.1007/s10995-023-03877-0. Epub 2024 Jan 10.

Pregnancy Planning and its Association with Autism Spectrum Disorder: Findings from the Study to Explore Early Development

Shericka T Harris  1 , Laura A Schieve  2 , Carolyn Drews-Botsch  3 , Carolyn DiGuiseppi  4 , Lin H Tian  2 , Gnakub N Soke  5 , Chyrise B Bradley  6 , Gayle C Windham  7
Affiliations

Pregnancy Planning and its Association with Autism Spectrum Disorder: Findings from the Study to Explore Early Development

Shericka T Harris et al. Matern Child Health J. 2024 May.

Abstract

Objectives: To examine associations between pregnancy planning and autism spectrum disorder (ASD) in offspring.

Methods: The Study to Explore Early Development (SEED), a multi-site case-control study, enrolled preschool-aged children with ASD, other DDs, and from the general population (POP). Some children with DDs had ASD symptoms but did not meet the ASD case definition. We examined associations between mother's report of trying to get pregnant (pregnancy planning) and (1) ASD and (2) ASD symptomatology (ASD group, plus DD with ASD symptoms group combined) (each vs. POP group). We computed odds ratios adjusted for demographic, maternal, health, and perinatal health factors (aORs) via logistic regression. Due to differential associations by race-ethnicity, final analyses were stratified by race-ethnicity.

Results: Pregnancy planning was reported by 66.4%, 64.8%, and 76.6% of non-Hispanic White (NHW) mothers in the ASD, ASD symptomatology, and POP groups, respectively. Among NHW mother-child pairs, pregnancy planning was inversely associated with ASD (aOR = 0.71 [95% confidence interval 0.56-0.91]) and ASD symptomatology (aOR = 0.67 [0.54-0.84]). Pregnancy planning was much less common among non-Hispanic Black mothers (28-32% depending on study group) and Hispanic mothers (49-56%) and was not associated with ASD or ASD symptomatology in these two race-ethnicity groups.

Conclusion: Pregnancy planning was inversely associated with ASD and ASD symptomatology in NHW mother-child pairs. The findings were not explained by several adverse maternal or perinatal health factors. The associations observed in NHW mother-child pairs did not extend to other race-ethnicity groups, for whom pregnancy planning was lower overall.

Keywords: Autism Spectrum Disorder; Developmental Disability; Pregnancy Intention; Pregnancy Planning; Race/ethnicity.

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Conflict of interest statement

Conflict of Interest All authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Percent of mothers who planned their pregnancy by study group and race-ethnicity in the Study to Explore Early Development. Abbreviations: ASD, autism spectrum disorder; ASD symptomatology, includes ASD and DD with autism symptoms; POP, population control group. *Indicates significant differences (p<0.05, based on chi-square test) between study groups (ASD vs POP and ASD symptomatology vs POP)
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