Autism After Infection, Febrile Episodes, and Antibiotic Use During Pregnancy: An Exploratory Study

Departments of Public Health, Section of Epidemiology and.
PEDIATRICS (Impact Factor: 5.47). 11/2012; 130(6). DOI: 10.1542/peds.2012-1107
Source: PubMed


Results of animal studies suggest that maternal immune activation during pregnancy causes deficiencies in fetal neurodevelopment. Infectious disease is the most common path to maternal immune activation during pregnancy. The goal of this study was to determine the occurrence of common infections, febrile episodes, and use of antibiotics reported by the mother during pregnancy and the risk for autism spectrum disorder (ASD) and infantile autism in the offspring.

We used a population-based cohort consisting of 96 736 children aged 8 to 14 years and born from 1997 to 2003 in Denmark. Information on infection, febrile episodes, and use of antibiotics was self-reported through telephone interviews during pregnancy and early postpartum. Diagnoses of ASD and infantile autism were retrieved from the Danish Psychiatric Central Register; 976 children (1%) from the cohort were diagnosed with ASD.

Overall, we found little evidence that various types of mild common infectious diseases or febrile episodes during pregnancy were associated with ASD/infantile autism. However, our data suggest that maternal influenza infection was associated with a twofold increased risk of infantile autism, prolonged episodes of fever caused a threefold increased risk of infantile autism, and use of various antibiotics during pregnancy were potential risk factors for ASD/infantile autism.

Our results do not suggest that mild infections, febrile episodes, or use of antibiotics during pregnancy are strong risk factors for ASD/infantile autism. The results may be due to multiple testing; the few positive findings are potential chance findings.

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Available from: Hjördís Osk Atladóttir, Apr 12, 2014
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    • "With advances in epidemiological research, it is becoming increasingly evident that prenatal exposure to infection likely plays a role in the etiology of various neuropsychiatric and neurological disorders, including schizophrenia (Brown and Derkits, 2010; Brown 2005; Mortensen et al., 2007; Sørensen HJ, 2009), autism (Atladóttir et al., 2012), bipolar disorder (Paarbosing 2013; Canetta 2014), mental retardation (Johnson et al., 2012), and cerebral palsy (Dammann 1997). Infection activate inflammatory pathways, causing the release of various proinflammatory biomarkers such as cytokines, interleukins, and other molecules. "
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    • "Maternal infectious or inflammatory insults during pregnancy have been repeatedly implicated in the etiology of developmental neuropsychiatric disorders, including schizophrenia (Brown and Derkits, 2010; Canetta et al., 2014b), autism (Atladóttir et al., 2012; Brown et al., 2014), and bipolar disorder (Canetta et al., 2014a; Parboosing et al., 2013). Preclinical support for these epidemiological associations has been obtained by various translational rodent models demonstrating multiple brain and behavioral abnormalities following prenatal exposure to infection and/or immune activation (reviewed in Boksa (2010), Harvey and Boksa (2012), Meyer (2014), Meyer and Feldon (2010)). "
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    • "Early life immune activation (e.g. infectious disease during pregnancy) is associated with a threefold increase in the risk of ASD (Atladóttir et al., 2012). Several studies have also described immune dysfunction in patients with ASD ranging from alterations of immune markers in blood to increased microglia activation in the central nervous system (CNS) (Hsiao, 2013). "
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