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Autism Spectrum Disorder Risk in Relation to Maternal Mid-Pregnancy Serum Hormone and Protein Markers from Prenatal Screening in California

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Abstract

We examined prenatal screening markers and offspring autism spectrum disorder (ASD) using California statewide data on singleton births in 1996 and 2002. Second trimester levels of unconjugated estriol (uE3), human chorionic gonadotropin (hCG), and maternal serum alpha-fetoprotein (MSAFP) were compared between mothers of children with ASD (n = 2586) and of non-cases (n = 600,103). Adjusted odds ratios (AOR) were calculated by logistic regression. Lower uE3 (AOR for < 10th percentile vs. 25th–74th percentiles = 1.21, 95 % CI 1.06–1.37), and higher MSAFP (AOR = 1.21, 95 % CI 1.07–1.37 for > 90th percentile) were significantly associated with ASD. A U-shaped relationship was seen for hCG (AOR = 1.16, 95 % CI 1.02–1.32 for < 10th percentile; AOR = 1.19, 95 % CI 1.05–1.36 for > 90th percentile). Our results further support prenatal hormone involvement in ASD risk.

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Acknowledgments

This work was funded by National Alliance for Autism Research (later Autism Speaks) grant # 1530/GW-201-006-065-00-00 to Impact Assessment, Inc. and was supported by the CA Department of Public Health in the form of staff time. We wish to thank Genetic Disease Screening Program staff for their contributions, including extensive background information on prenatal screening data from Dr. Robert J. Currier, and record linkage between prenatal screening and live birth data by Allen Hom (Sequoia Foundation). We also thank the Department of Developmental Services for on-going collaboration in the form of data provision to examine risk factors and trends for autism, as well as Karen Smith, CDPH, and IAI for project management. All views presented are those of the authors only. Portions of this work were presented previously at IMFAR.

Author Contributions

GCW conceived of the study, designed it, oversaw all aspects including analyses, drafted reports and coordinated writing of the manuscript; KL conducted analyses of the data, designed figures, and participated in the primary drafting of the manuscript; MA carried out data linkages, performed statistical analyses, and reviewed drafts of the manuscript; MK provided genetic disease screening data, helped interpret the findings, and commented on drafts of the manuscript. All authors read and approved the final manuscript.

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  1. Kristen Lyall

    Present address: A. J. Drexel Autism Inst., Drexel University, Philadelphia, PA, 19104, USA

  2. Martin Kharrazi

    Present address: California Department of Public Health, Division of Environmental and Occupational Disease Control, Environmental Health Investigations Branch, 850 Marina Bay Parkway, Richmond, CA, 94804, USA

Authors and Affiliations

  1. California Department of Public Health, Division of Environmental and Occupational Disease Control, Environmental Health Investigations Branch, 850 Marina Bay Parkway, Richmond, CA, 94804, USA

    Gayle C. Windham & Kristen Lyall

  2. Impact Assessment Inc., 2166 Avenida de la Playa, Suite F, La Jolla, CA, 92037, USA

    Meredith Anderson

  3. California Department of Public Health, Genetics Disease Screening Program, 850 Marina Bay Parkway, Richmond, CA, 94804, USA

    Martin Kharrazi

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  1. Gayle C. Windham
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Correspondence to Gayle C. Windham.

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Windham, G.C., Lyall, K., Anderson, M. et al. Autism Spectrum Disorder Risk in Relation to Maternal Mid-Pregnancy Serum Hormone and Protein Markers from Prenatal Screening in California. J Autism Dev Disord 46, 478–488 (2016). https://doi.org/10.1007/s10803-015-2587-2

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