Abstract
This study aimed to investigate the association between prenatal education and autistic-like behaviors of preschoolers as well as the mediating role of breastfeeding in their associations. A cross-sectional study via a structured questionnaire was conducted with 67,578 preschool children and parents from Longhua District of Shenzhen, China. Hierarchical logistic regression models were performed to explore the associations between maternal participation in prenatal education and autistic-like behaviors in preschoolers, as well as the mediating effect of breastfeeding in the associations. After controlling for potential confounders, logistic regression analysis indicated that maternal participation in prenatal education could significantly increase the prevalence of breastfeeding, and the strength of the association was enhanced with the increase frequency of prenatal education visits (ORs ranging from 1.191 to 1.899). While both maternal participation in prenatal education (ORs ranging from 0.732 to 0.798) and breastfeeding (OR = 0.773) were significantly associated with the lower presence of autistic-like behaviors in preschoolers. The crossover analysis indicated that children with both maternal prenatal education and breastfeeding had the lower risk of presence of autistics-like behaviors (OR = 0.569). Furthermore, mediation analysis illustrated that breastfeeding mediated the association between maternal participation in prenatal education and the presence of autistic-like behaviors in preschoolers, with a mediating effect of approximately 14.3%. Our findings suggest that maternal participation in prenatal education is significantly associated with a decreased risk of autistic-like behaviors in preschool children through increased breastfeeding in the mothers who attended prenatal education.
Highlights
Autism spectrum disorder (ASD) is a pervasive developmental disorder characterized by social impairment, restrictive interests and cognitive inflexibility, with its main symptoms including social communication barriers, language barriers and repetitive stereotyped behavior [1]
After controlling for the aforementioned covariates, the analysis indicated that maternal participation in prenatal education and breastfeeding (OR = 0.773, 95% CI = 0.676–0.884) were significantly associated with the less autistic-like behaviors in preschoolers
To investigate the effect of maternal prenatal education attendance on autistic-like behaviors in preschoolers and its potential pathway, we conducted a cross-sectional study with 67,578 preschool children and their mothers from Longhua New District of Shenzhen, China
Summary
Autism spectrum disorder (ASD) is a pervasive developmental disorder characterized by social impairment, restrictive interests and cognitive inflexibility, with its main symptoms including social communication barriers, language barriers and repetitive stereotyped behavior [1]. ASD is manifested before the age of three, but most children with. ASD are not clinically diagnosed until the age of three or later [2]. Autistic-like behaviors, an important clinical manifestation for the diagnosis of ASD, include social interaction and communication disorders [3,4], language development disorders [5], repetitive behaviors and parochial interests [6,7]. A systematic review revealed that the prevalence of ASD was 2.64% in China [11]. Constantino’s and Charman’s findings indicate that autistic traits are continuously distributed in the general population [13]
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