(595) Examining the Relationship between Maternal Preeclampsia and Autism Spectrum Disorder in Childhood: A Cohort Analysis

Objective: Autism spectrum disorder (ASD) is of multifactorial origin, with some factors thought to be related to the prenatal period. Preeclampsia (PET) is a prevalent and serious pregnancy complication that is considered a disease with multiple contributing factors. This study was aimed to investigate the potential association between these two morbidities within our diverse population.

Study Design: A population-based cohort analysis using data from community clinics and a tertiary referral hospital was conducted. The analysis specifically focused on deliveries that took place between 2005 and 2017, considering that individuals born after this period might be too young to receive an ASD diagnosis. The aim was to compare the incidence of ASD in offspring based on whether their mothers had been diagnosed with PET of varying severities, or not. To evaluate the cumulative incidence of ASD, we employed a Kaplan-Meier survival curve. Additionally, a Cox proportional hazards model was utilized to account for potential confounding factors.

Results: Out of 165,689 parturient in the study, 4,268 (2.6%) were diagnosed with PET and 1,351 (0.8%) with PET with severe features (severe PET). PET, especially the severe form, was associated with adverse obstetrical outcomes, including intrauterine growth restriction, non-reassuring fetal heart rate tracing, earlier delivery, cesarean delivery, and lower birth weight (p< 0.001 for all;table). Out of 862 offspring diagnosed with ASD during childhood, the prevalence was higher in the PET group (0.5% for no PET, 0.8% for PET, and 0.7% for severe PET; p=0.009;table). However, the cumulative ASD morbidity derived from the Kaplan-Meier survival curve showed no significant difference among the groups (p-value=0.901; figure). Following adjustment for factors such as gestational age, maternal age, mode of delivery, and gender, the association between PET and ASD was no longer statistically significant.

Conclusion: In the endeavour to gain a deeper understanding of the obstetrical aspects related to the development of ASD, our findings indicate that PET does not play a contributory role.