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Abstract
BackgroundNausea and vomiting during pregnancy (NVP) is thought to be caused by changes in maternal hormones during pregnancy. Differences in hormone exposure during prenatal life have been implicated in the causal pathways for some cases of autism spectrum disorder (ASD). However, no study has investigated whether the presence and severity of NVP may be related to symptom severity in offspring with ASD.MethodsA large sample of children with ASD (227 males and 60 females, aged 2 to 18 years) received a clinical assessment, during which parents completed questionnaires regarding their child’s social (Social Responsiveness Scale, SRS) and communication (Children’s Communication Checklist–2nd edition, CCC-2) symptoms. Parents also reported on a 5-point scale the frequency and severity of NVPs during the pregnancy of the child being assessed: (1) no NVP during the pregnancy, (2) occasional nausea, but no vomiting, (3) daily nausea, but no vomiting, (4) occasional vomiting, with or without nausea, and (5) daily nausea and vomiting.ResultsImpairments in social responsiveness in offspring, as indexed by SRS total score, significantly increased as a function of the frequency and severity of their mothers’ NVP, as did the level of language difficulties as indexed by the Global Communication Composite of the CCC-2.ConclusionsThe strong, positive association between increasing frequency and severity of NVP and ASD severity in offspring provides further evidence that exposure to an atypical hormonal environment during prenatal life may affect neurodevelopment and contribute to the ASD phenotype. Given that the measure of NVP symptoms in the current study was based on retrospective recall, replication of this finding is required before strong conclusions can be drawn.
Highlights
Nausea and vomiting during pregnancy (NVP) is thought to be caused by changes in maternal hormones during pregnancy
While it is important to highlight that these findings have not always been replicated [4, 9], further support for the potential role of the prenatal hormone environment in the etiological pathways contributing to autism spectrum disorder (ASD) has been observed through associations with factors known to influence maternal hormone status, such as maternal age at menarche [10], pre-pregnancy BMI [11], and infertility and its treatments [10, 12]
The current study provides the first investigation of whether maternal NVP relates to symptom severity in children with ASD
Summary
Nausea and vomiting during pregnancy (NVP) is thought to be caused by changes in maternal hormones during pregnancy. While it is important to highlight that these findings have not always been replicated [4, 9], further support for the potential role of the prenatal hormone environment in the etiological pathways contributing to ASD has been observed through associations with factors known to influence maternal hormone status, such as maternal age at menarche [10], pre-pregnancy BMI [11], and infertility and its treatments [10, 12]. This evidence strongly supports the further examination of how prenatal endocrine factors may contribute to ASD. A number of large studies have identified an association between maternal autoimmune thyroid disease during pregnancy and risk for ASD [22, 23], with a recent meta-analysis reporting a pooled odds ratio of 1.29 (95% confidence interval 1.14–1.45) [24]
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