Maternal Exposure to Intimate Partner Abuse Prior to Birth Is Associated with Risk of Autism In Offspring

Thursday, May 17, 2012
Sheraton Hall (Sheraton Centre Toronto)
1:00 PM
A. L. Roberts1, K. Lyall2,3, J. W. Rich-Edwards4, A. Ascherio5 and M. G. Weisskopf6, (1)Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA, (2)Harvard School of Public Health, Boston, MA, (3)University of California, Davis, MIND Institute, Sacramento, CA, (4)Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital, Boston, MA, (5)Department of Epidemiology, Harvard School of Public Health, Boston, MA, (6)Department of Environmental Health, Harvard School of Public Health, Boston, MA
Background: Exposure to psychosocial stressors during pregnancy has been hypothesized to increase risk of autism spectrum disorder in offspring, yet existing evidence is contradictory.  Intimate partner abuse is a severe psychosocial stressor, thus maternal exposure may increase risk of autism.

Objectives: To determine whether maternal exposure to i) injurious physical abuse in pregnancy or ii) fear of partner or sexual, emotional, or physical abuse prior to the birth of the child increases risk of autism in a large community-based cohort.

Methods: Participants were women in the Nurses Health Study II  (97% White) and their children born 1962 to 2003 (54,512 without autism spectrum disorder (autism), 451 with autism).  We calculated risk ratios (RR) for autism diagnosis reported by mothers (validated by Autism Diagnostic Interview-Revised in a subsample), adjusted for maternal age at birth, birth year, sex of child, and maternal childhood socioeconomic status.

Results: Injurious physical abuse during pregnancy (reported by 2.4% of women) was not related to autism.  In contrast, autism risk was increased in children of the 11.7% of women who reported fear of partner or emotional, physical, or sexual abuse in the two years before the birth year.   Risk ratio for autism was 2.23 (95% confidence interval (CI)=1.48, 3.36) for exposure to abuse in the year before the birth year and 2.62 (95% CI=1.59, 4.33) for exposure in both of the two years before the birth year, compared to women unexposed.  Exposure in the 3 to 10 years before the birth year, the year of birth, and the 4 years following the birth year was not associated with autism.

Conclusions: Although exposure to injurious physical abuse during pregnancy was not associated with autism risk, fear of partner or emotional, sexual, or physical abuse in the years immediately before the birth year may be associated with risk of autism spectrum disorder in children.

| More