859 Sex hormone-binding globulin is decreased in hypertensive pregnancies with offspring affected by autism spectrum disorder

Abstract

To determine whether sex hormone-binding globulin (SHBG) steroid dysregulation is associated with autism spectrum disorder (ASD) in hypertensive pregnancies. SHBG concentrations were measured in second trimester serum of women enrolled in Utah’s First and Second Trimester Evaluation of Risk (FASTER) study, a multi-center cohort study for aneuploidy screening. ASD case status was determined by linking offspring to an ASD master case list within the Utah Population Database. Obstetric variables (e.g., gestational age, maternal age, pregnancy weight gain, pre-pregnancy BMI, gestational/pre-existing diabetes, and hypertension) were abstracted from birth certificate data. The relationship between SHBG levels and offspring ASD case status was analyzed using multivariate logistic regression for pregnancies complicated by hypertension. Covariates include the remaining obstetric variables listed above. SHBG levels were significantly lower in hypertensive pregnancies associated with ASD among offspring (mean=137.11 nmol/L, 95% CI 117.56 - 156.66 vs. mean=220.45 nmol/L, 95% CI 168.56 - 272.34, ASD vs. without ASD, respectively). Previous studies have demonstrated the association between prenatal metabolic syndrome (PNMS) and increased ASD risk, while other investigations have linked decreased serum SHBG levels to insulin resistance and ASD co-occurrence. It is unclear which component medical condition of PNMS – hypertension, diabetes, or obesity – is the primary variable driving the association between ASD and PNMS as these variables are frequently comorbid. This study concludes that lower SHBG levels are associated with ASD in offspring of hypertensive pregnancies after controlling for confounding variables. SHBG should be included in future serum biomarker studies investigating the link between ASD and PNMS.