title: The perinatal androgen to estrogen ratio and autistic-like traits in the general population: a longitudinal pregnancy cohort study.
abstract: BACKGROUND
  Prenatal androgen exposure has been hypothesized to be linked to autism spectrum disorder (ASD). While previous studies have found a link between testosterone levels in amniotic fluid and autistic-like traits, a similar relationship has not been found for testosterone in umbilical cord blood. However, it may be the net biological activity of multiple androgens and estrogens that influences postnatal effects of prenatal sex steroids. Accordingly, composite levels of androgens (A) and estrogens (E) were investigated, along with their ratio, in relation to autistic-like traits in young adulthood.
  
  
  METHODS
  Sex steroid data in umbilical cord blood were available from 860 individuals at delivery. Samples were analyzed for androgens (testosterone, androstenedione, and dehydroepiandrosterone) and estrogens (estrone, estradiol, estriol, and estetrol). Levels of bioavailable testosterone, estradiol, and estrone were measured and used to calculate A and E composites and the A to E ratio. Participants were approached in early adulthood to complete the autism-spectrum quotient (AQ) as a self-report measure of autistic-like traits, with 183 males (M = 20.10 years, SD = 0.65 years) and 189 females (M =19.92 years, SD = 0.68 years) providing data.
  
  
  RESULTS
  Males exhibited significantly higher androgen composites and A to E composite ratios than females. Males also scored significantly higher on the details/patterns subscale of the AQ. Subsequent categorical and continuous analyses, which accounted for covariates, revealed no substantial relationships between the A/E composites or the A to E ratio and the AQ total or subscale scores.
  
  
  CONCLUSIONS
  The current study found no link between the A/E composites or the A to E ratio in cord blood and autistic-like traits in the population as measured by the AQ. These outcomes do not exclude the possibility that these sex steroid variables may predict other neurodevelopmental traits in early development.
authors.affiliation: School of Psychology, University of Western Australia, 35 Stirling Hwy, Crawley, WA 6009 Australia ; Telethon Kids Institute, Centre for Child Health Research, University of Western Australia, 100 Roberts Road, Subiaco, WA 6008 Australia.
authors.forename: Esha S L
authors.initials: ES
authors.lastname: Jamnadass
authors.affiliation: School of Women's and Infant's Health, University of Western Australia, Perth, Australia.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Keelan
authors.affiliation: Faculty of Health Sciences, Curtin University, Kent Street, Bentley, Western Australia 6102 Australia.
authors.forename: Lauren P
authors.initials: LP
authors.lastname: Hollier
authors.affiliation: Department of Obstetrics and Gynaecology, University of Melbourne and the Royal Women's Hospital, Victoria, Australia.
authors.forename: Martha
authors.initials: M
authors.lastname: Hickey
authors.affiliation: School of Psychology, University of Western Australia, 35 Stirling Hwy, Crawley, WA 6009 Australia.
authors.forename: Murray T
authors.initials: MT
authors.lastname: Maybery
authors.affiliation: Telethon Kids Institute, Centre for Child Health Research, University of Western Australia, 100 Roberts Road, Subiaco, WA 6008 Australia.
authors.forename: Andrew J O
authors.initials: AJ
authors.lastname: Whitehouse
keywords: Androgens; Autism-Spectrum Quotient; Autistic-like traits; Cord blood; Estrogens; Perinatal; Sex steroids