title: Maternal metabolic conditions and risk for autism and other neurodevelopmental disorders.
abstract: OBJECTIVE
  We examined whether metabolic conditions (MCs) during pregnancy (diabetes, hypertension, and obesity) are associated with autism spectrum disorder (ASD), developmental delays (DD), or impairments in specific domains of development in the offspring.
  
  
  METHODS
  Children aged 2 to 5 years (517 ASD, 172 DD, and 315 controls) were enrolled in the CHARGE (Childhood Autism Risks from Genetics and the Environment) study, a population-based, case-control investigation between January 2003 and June 2010. Eligible children were born in California, had parents who spoke English or Spanish, and were living with a biological parent in selected regions of California. Children's diagnoses were confirmed by using standardized assessments. Information regarding maternal conditions was ascertained from medical records or structured interview with the mother.
  
  
  RESULTS
  All MCs were more prevalent among case mothers compared with controls. Collectively, these conditions were associated with a higher likelihood of ASD and DD relative to controls (odds ratio: 1.61 [95% confidence interval: 1.10-2.37; odds ratio: 2.35 [95% confidence interval: 1.43-3.88], respectively). Among ASD cases, children of women with diabetes had Mullen Scales of Early Learning (MSEL) expressive language scores 0.4 SD lower than children of mothers without MCs (P < .01). Among children without ASD, those exposed to any MC scored lower on all MSEL and Vineland Adaptive Behavior Scales (VABS) subscales and composites by at least 0.4 SD (P < .01 for each subscale/composite).
  
  
  CONCLUSIONS
  Maternal MCs may be broadly associated with neurodevelopmental problems in children. With obesity rising steadily, these results appear to raise serious public health concerns.
authors.affiliation: Division of Epidemiology, Department of Public Health Sciences, University of California, Davis, California, USA. pkrakowiak@ucdavis.edu
authors.forename: Paula
authors.initials: P
authors.lastname: Krakowiak
authors.forename: Cheryl K
authors.initials: CK
authors.lastname: Walker
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Bremer
authors.forename: Alice S
authors.initials: AS
authors.lastname: Baker
authors.forename: Sally
authors.initials: S
authors.lastname: Ozonoff
authors.forename: Robin L
authors.initials: RL
authors.lastname: Hansen
authors.forename: Irva
authors.initials: I
authors.lastname: Hertz-Picciotto
mesh_terms: D002140:California; D002659:Child Development Disorders, Pervasive / Q000453:epidemiology* / Q000209:etiology*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D002658:Developmental Disabilities / Q000453:epidemiology* / Q000209:etiology*; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000175:diagnosis* / Q000453:epidemiology; D007805:Language Development Disorders / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis* / Q000453:epidemiology*; D009765:Obesity / Q000175:diagnosis* / Q000453:epidemiology*; D016017:Odds Ratio; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000175:diagnosis / Q000453:epidemiology; D012307:Risk Factors; D013223:Statistics as Topic