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Obstetric and Parental Psychiatric Variables as Potential Predictors of Autism Severity

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Abstract

Associations between obstetric and parental psychiatric variables and subjects’ Autism Diagnostic Interview-Revised (ADI-R) and Autism Diagnostic Observation Schedule (ADOS) domain scores were examined using linear mixed effects models. Data for the 228 families studied were provided by the Autism Genetic Resource Exchange. Hypertension (P = 0.002), preeclampsia (P = 0.021) and generalized edema (P = 0.011) were associated with higher ADI-R communication scores. Hypertension (P = 0.011), albuminuria (P = 0.039) and generalized edema (P = 0.009) were associated with higher ADI-R repetitive behaviors scores. Parent depression was associated with higher ADI-R repetitive behaviors scores (P = 0.005), and parent anxiety with lower ADOS social/communication composite scores (P = 0.025). The associations between hypertension-related obstetric conditions and autistic severity warrant further investigation and raise intriguing questions regarding potential causal and modifying factors in autism.

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References

  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC.

  • Anderson, G. M., Jacobs-Stannard, A., Chawarska, K., Volkmar, F. R., & Kliman, H. J. (2007). Placental trophoblast inclusions in autism spectrum disorder. Biological Psychiatry, 61(4), 487–491.

    Article  PubMed  Google Scholar 

  • Bailey, A., Le Couteur, A., Gottesman, I., Bolton, P., Simonoff, E., Yuzda, E., et al. (1995). Autism as a strongly genetic disorder: Evidence from a british twin study. Psychological Medicine, 25(1), 63–77.

    Article  PubMed  Google Scholar 

  • Bolton, P. F., Pickles, A., Murphy, M., & Rutter, M. (1998). Autism, affective and other psychiatric disorders: Patterns of familial aggregation. Psychological Medicine, 28(2), 385–395.

    Article  PubMed  Google Scholar 

  • Bryson, S. E., Smith, I. M., & Eastwood, D. (1988). Obstetrical suboptimality in autistic children. Journal of the American Academy of Child and Adolescent Psychiatry, 27(4), 418–422.

    Article  PubMed  Google Scholar 

  • CDC (Centers for Disease Control and Prevention). (2007). Prevalence of Autism Spectrum Disorders—Autism and Developmental Disabilities Monitoring Network, Six Sites, United States, 2000; Prevalence of Autism Spectrum Disorders—Autism and Developmental Disabilities Monitoring Network, 14 Sites, United States, 2002; and Evaluation of a Methodology for a Collaborative Multiple Source Surveillance Network for Autism Spectrum Disorders—Autism and Developmental Disabilities Monitoring Network, 14 Sites, United States, 2002. Surveillance Summaries. MMWR 2007;56(No. SS-1).

  • Connors, S. L., Crowell, D. E., Eberhart, C. G., Copeland, J., Newschaffer, C. J., Spence, S. J., et al. (2005). Beta2-adrenergic receptor activation and genetic polymorphisms in autism: Data from dizygotic twins. Journal of Child Neurology, 20(11), 876–884.

    Article  PubMed  Google Scholar 

  • Conroy, J., Meally, E., Kearney, G., Fitzgerald, M., Gill, M., & Gallagher, L. (2004). Serotonin transporter gene and autism: A haplotype analysis in an Irish autistic population. Molecular Psychiatry, 9(6), 587–593.

    Article  PubMed  Google Scholar 

  • Constantino, J. N., Davis, S. A., Todd, R. D., Schindler, M. K., Gross, M. M., Brophy, S. L., et al. (2003). Validation of a brief quantitative measure of autistic traits: comparison of the Social Responsiveness Scale with the Autism Diagnostic Interview-Revised. Journal of Autism & Developmental Disorders, 33(4), 427–433.

    Article  Google Scholar 

  • Coon, H., Dunn, D., Lainhart, J., Miller, J., Hamil, C., Battaglia, A., et al. (2005). Possible association between autism and variants in the brain-expressed tryptophan hydroxylase gene (TPH2). American Journal of Medical Genetics B Neuropsychiatry Genetics, 135(1), 42–46.

    Article  Google Scholar 

  • de Bildt, A., Sytema, S., Ketelaars, C., Kraijer, D., Mulder, E., Volkmar, F., et al. (2004). Interrelationship between Autism Diagnostic Observation Schedule-Generic (ADOS-G), Autism Diagnostic Interview-Revised (ADI-R), and the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) classification in children and adolescents with mental retardation. Journal of Autism and Developmental Disorders, 34(2), 129–137.

    Article  PubMed  Google Scholar 

  • DeLong, G. R., Teague, L. A., & McSwain Kamran, M. (1998). Effects of fluoxetine treatment in young children with idiopathic autism. Developmental Medicine and Child Neurology, 40(8), 551–562.

    PubMed  Google Scholar 

  • Devlin, B., Cook, E. H., Coon, H., Dawson, G., Grigorenko, E. L., McMahon, W., et al. (2005). Autism and the serotonin transporter: The long and short of it. Molecular Psychiatry, 10(12), 1110–1116.

    Article  PubMed  Google Scholar 

  • Deykin, E. Y., & MacMahon, B. (1980). Pregnancy, delivery, and neonatal complications among autistic children. American Journal of Diseases of Children, 134(9), 860–864.

    PubMed  Google Scholar 

  • Feinstein, C., & Singh, S. (2007). Social phenotypes in neurogenetic syndromes. Child & Adolescent Psychiatric Clinics of North America, 16(3), 631–647.

    Article  Google Scholar 

  • Gillberg, C., & Gillberg, I. C. (1983). Infantile autism: A total population study of reduced optimality in the pre-, peri-, and neonatal period. Journal of Autism and Developmental Disorders, 13(2), 153–166.

    Article  PubMed  Google Scholar 

  • Glasson, E. J., Bower, C., Petterson, B., de Klerk, N., Chaney, G., & Hallmayer, J. F. (2004). Perinatal factors and the development of autism: A population study. Archives of General Psychiatry, 61(6), 618–627.

    Article  PubMed  Google Scholar 

  • Hultman, C. M., Sparen, P., & Cnattingius, S. (2002). Perinatal risk factors for infantile autism. Epidemiology, 13(4), 417–423.

    Article  PubMed  Google Scholar 

  • Kessler, R. C., Chiu, W. T., Demler, O., Merikangas, K. R., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey replication. Archives of General Psychiatry, 62(6), 617–627.

    Article  PubMed  Google Scholar 

  • Kronenberg, M. E., Raz, S., & Sander, C. J. (2006). Neurodevelopmental outcome in children born to mothers with hypertension in pregnancy: The significance of suboptimal intrauterine growth. Developmental Medicine and Child Neurology, 48(3), 200–206.

    Article  PubMed  Google Scholar 

  • Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Leventhal, B. L., DiLavore, P. C., et al. (2000). The Autism Diagnostic Observation Schedule-Generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30(3), 205–223.

    Article  PubMed  Google Scholar 

  • Lord, C., Rutter, M., & Le Couteur, A. (1994). Autism Diagnostic Interview-Revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24(5), 659–685.

    Article  PubMed  Google Scholar 

  • Ma, D. Q., Whitehead, P. L., Menold, M. M., Martin, E. R., Ashley-Koch, A. E., Mei, H., et al. (2005). Identification of significant association and gene-gene interaction of GABA receptor subunit genes in autism. American Journal of Human Genetics, 77(3), 377–388.

    Article  PubMed  Google Scholar 

  • Mason-Brothers, A., Ritvo, E. R., Guze, B., Mo, A., Freeman, B. J., Funderburk, S. J., et al. (1987). Pre-, peri-, and postnatal factors in 181 autistic patients from single and multiple incidence families. Journal of the American Academy of Child and Adolescent Psychiatry, 26(1), 39–42.

    Article  PubMed  Google Scholar 

  • Mason-Brothers, A., Ritvo, E. R., Pingree, C., Petersen, P. B., Jenson, W. R., McMahon, W. M., et al. (1990). The UCLA-University of Utah Epidemiologic Survey of Autism: Prenatal, perinatal, and postnatal factors. Pediatrics, 86(4), 514–519.

    PubMed  Google Scholar 

  • Matsuishi, T., Yamashita, Y., Ohtani, Y., Ornitz, E., Kuriya, N., Murakami, Y., et al. (1999). Brief report: Incidence of and risk factors for autistic disorder in neonatal intensive care unit survivors. Journal of Autism and Developmental Disorders, 29(2), 161–166.

    Article  PubMed  Google Scholar 

  • McBride, P. A., Anderson, G. M., & Shapiro, T. (1996). Autism research. Bringing together approaches to pull apart the disorder. Archives of General Psychiatry, 53, 980–983.

    PubMed  Google Scholar 

  • McCauley, J. L., Olson, L. M., Dowd, M., Amin, T., Steele, A., Blakely, R. D., et al. (2004). Linkage and association analysis at the serotonin transporter (SLC6A4) locus in a rigid-compulsive subset of autism. American Journal of Medical Genetics B Neuropsychiatry Genetics, 127(1), 104–112.

    Article  Google Scholar 

  • Micali, N., Chakrabarti, S., & Fombonne, E. (2004). The broad autism phenotype: Findings from an epidemiological survey. Autism, 8(1), 21–37.

    Article  PubMed  Google Scholar 

  • Moore, M. L., Eichner, S. F., & Jones, J. R. (2004). Treating functional impairment of autism with selective serotonin-reuptake inhibitors. Annals of Pharmacotherapy, 38(9), 1515–1519.

    Article  PubMed  Google Scholar 

  • Mulder, E. J., Anderson, G. M., Kema, I. P., Brugman, A. M., Ketelaars, C. E., de Bildt, A., et al. (2005). Serotonin transporter intron 2 polymorphism associated with rigid-compulsive behaviors in Dutch individuals with pervasive developmental disorder. American Journal of Medical Genetics B Neuropsychiatry Genetics, 133(1), 93–96.

    Article  Google Scholar 

  • Murphy, M., Bolton, P. F., Pickles, A., Fombonne, E., Piven, J., & Rutter, M. (2000). Personality traits of the relatives of autistic probands. Psychological Medicine, 30(6), 1411–1424.

    Article  PubMed  Google Scholar 

  • Ozaki, N., Goldman, D., Kaye, W. H., Plotnicov, K., Greenberg, B. D., Lappalainen, J., et al. (2003). Serotonin transporter missense mutation associated with a complex neuropsychiatric phenotype. Molecular Psychiatry, 8(11), 895, 933–936.

    Google Scholar 

  • Paul, R., Miles, S., Cicchetti, D., Sparrow, S., Klin, A., Volkmar, F., et al. (2004). Adaptive behavior in autism and pervasive developmental disorder-not otherwise specified: microanalysis of scores on the Vineland Adaptive Behavior Scales. Journal of Autism & Developmental Disorders, 34(2), 223–228.

    Article  Google Scholar 

  • Piven, J., & Palmer, P. (1999). Psychiatric disorder and the broad autism phenotype: Evidence from a family study of multiple-incidence autism families. The American Journal of Psychiatry, 156(4), 557–563.

    PubMed  Google Scholar 

  • Rubenstein, J. L., & Merzenich, M. M. (2003). Model of autism: Increased ratio of excitation/inhibition in key neural systems. Genes, Brain, and Behavior, 2(5), 255–267.

    Article  PubMed  Google Scholar 

  • Spiker, D., Lotspeich, L. J., Dimiceli, S., Myers, R. M., & Risch, N. (2002). Behavioral phenotypic variation in autism multiplex families: Evidence for a continuous severity gradient. American Journal of Medical Genetics, 114(2), 129–136.

    Article  PubMed  Google Scholar 

  • Steffenburg, S., Gillberg, C., Hellgren, L., Andersson, L., Gillberg, I. C., Jakobsson, G., et al. (1989). A twin study of autism in Denmark, Finland, Iceland, Norway and Sweden. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 30(3), 405–416.

    Article  PubMed  Google Scholar 

  • Stein, D., Weizman, A., Ring, A., & Barak, Y. (2006). Obstetric complications in individuals diagnosed with autism and in healthy controls. Comprehensive Psychiatry, 47(1), 69–75.

    Article  PubMed  Google Scholar 

  • Strömland, K., Nordin, V., Miller, M., Akerström, B., & Gillberg, C. (1994). Autism in thalidomide embryopathy: a population study. Developmental Medicine and Child Neurology, 36(4), 351–356.

    Article  PubMed  Google Scholar 

  • Sugie, Y., Sugie, H., Fukuda, T., Ito, M., Sasada, Y., Nakabayashi, M., et al. (2005). Clinical efficacy of fluvoxamine and functional polymorphism in a serotonin transporter gene on childhood autism. Journal of Autism and Developmental Disorders, 35(3), 377–385.

    Article  PubMed  Google Scholar 

  • Sung, Y. J., Dawson, G., Munson, J., Estes, A., Schellenberg, G. D., & Wijsman, E. M. (2005). Genetic investigation of quantitative traits related to autism: Use of multivariate polygenic models with ascertainment adjustment. American Journal of Human Genetics, 76(1), 68–81.

    Article  PubMed  Google Scholar 

  • Sutcliffe, J. S., Delahanty, R. J., Prasad, H. C., McCauley, J. L., Han, Q., Jiang, L., et al. (2005). Allelic heterogeneity at the serotonin transporter locus (SLC6A4) confers susceptibility to autism and rigid-compulsive behaviors. American Journal of Human Genetics, 77(2), 265–279.

    Article  PubMed  Google Scholar 

  • Szatmari, P., Merette, C., Bryson, S. E., Thivierge, J., Roy, M. A., Cayer, M., et al. (2002). Quantifying dimensions in autism: a factor-analytic study. Journal of the American Academy of Child & Adolescent Psychiatry, 46(4), 467–474.

    Article  Google Scholar 

  • Venter, A., Lord, C., & Schopler, E. (1992). A follow-up study of high-functioning autistic children. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 33(3), 489–507.

    Article  PubMed  Google Scholar 

  • Williams, G., King, J., Cunningham, M., Stephan, M., Kerr, B., & Hersh, J. H. (2001). Fetal valproate syndrome and autism: Additional evidence of an association. Developmental Medicine and Child Neurology, 43(3), 202–206.

    Article  PubMed  Google Scholar 

  • Wilkerson, D. S., Volpe, A. G., Dean, R. S., & Titus, J. B. (2002). Perinatal complications as predictors of infantile autism. The International Journal of Neuroscience, 112(9), 1085–1098.

    Article  PubMed  Google Scholar 

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Acknowledgements

We gratefully acknowledge the resources provided by the Autism Genetic Resource Exchange (AGRE) Consortium and thank the participating AGRE families for their critical role in making this study possible. The Autism Genetic Resource Exchange is a program of Cure Autism Now and is supported, in part, by grant MH64547 from the National Institute of Mental Health to Daniel H. Gershwind (PI). Dr. Anderson acknowledges support of the Korczak Foundation for Research on Autism and Related Disorders (Amsterdam). Dr. Sherin Stahl of the Yale Child Study Center commented helpfully on the manuscript and aspects of the study were fruitfully discussed with Dr. Harvey Kliman, Dept. of Obstetrics and Gynecology, Yale University School of Medicine.

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  1. Anna E. Wallace

    Present address: HealthCore, Inc., 800 Delaware Avenue, Fifth Floor, Wilmington, DE, 19801-1366, USA

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  1. Yale School of Public Health, New Haven, CT, USA

    Anna E. Wallace & Robert Dubrow

  2. Child Study Center, Yale University School of Medicine, New Haven, CT, USA

    George M. Anderson

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Wallace, A.E., Anderson, G.M. & Dubrow, R. Obstetric and Parental Psychiatric Variables as Potential Predictors of Autism Severity. J Autism Dev Disord 38, 1542–1554 (2008). https://doi.org/10.1007/s10803-007-0536-4

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