Prenatal Diet as a Modifier of Environmental Risk Factors for Autism and Related Neurodevelopmental Outcomes

Bragg, Megan G; Chavarro, Jorge E.; Hart, Jaime E.; Tabb, Loni Philip; Weisskopf, Marc G.; Volk, Heather E.; Lyall, Kristen

doi:10.1007/s40572-022-00347-7

Cited by 15 publications

(8 citation statements)

References 78 publications

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“…Previous studies reported changes in DNA methylation in cord blood and in adolescent plasma in relation to prenatal PFAS exposure, which could be a potential pathway on how folate may mitigate PFAS-related health outcomes. Indeed, folate is able to counteract the deleterious health effects triggered by other environmental pollutants. − Further, our previous study found consistent negative associations for folate status and serum PFAS concentrations in a large sample of U.S. adolescents and adults, and recent experimental evidence supports that spinach and soybean, which contain high amounts of folate, could reduce the absorption for PFOA and hexafluoropropylene oxide trimer acid, which is a PFOA alternative, in mice . Combined with results from our current study, the existing findings implicate that optimal medium/long-term folate intake could reduce overall PFAS body burden and further counteract PFAS-related harmful effects on the immune system.…”

Section: Discussionsupporting

confidence: 82%

Red Blood Cell Folate Modifies the Association between Serum Per- and Polyfluoroalkyl Substances and Antibody Concentrations in U.S. Adolescents

Zhang

Mustieles

Wang

et al. 2023

Environ. Sci. Technol.

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Per-and polyfluoroalkyl substances (PFAS) exposure has been associated with reduced antibody levels. Higher red blood cell (RBC) folate was previously associated with lower serum PFAS concentrations in adolescents. This study included 819 adolescents aged 12−19 years who had detectable rubella and measles antibody levels in serum from the U.S. National Health and Nutrition Examination Survey 2003−2004 and 2009−2010 cycles.We found inverse associations between serum PFOS and PFHxS and rubella antibodies, between PFOA and mumps antibodies, and between PFAS mixtures and rubella and mumps antibodies, only among adolescents with RBC folate concentrations <66th percentile (lower folate group) while not among adolescents with higher RBC folate levels (upper folate group). Specifically, per quartile increase in serum concentrations of the total PFAS mixture was associated with a 9.84% (95% CI: −15.57%, −3.74%) decrease in rubella antibody and an 8.79% (95% CI: −14.39%, −2.82%) decrease in the mumps antibody concentrations only in the lower folate group, while null associations were found for the upper folate group. If confirmed in mechanistic studies or prospective epidemiologic studies, these findings may have important implications for using folate as a mitigation measure against immunerelated PFAS effects.

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Section: Discussionsupporting

confidence: 82%

Red Blood Cell Folate Modifies the Association between Serum Per- and Polyfluoroalkyl Substances and Antibody Concentrations in U.S. Adolescents

Zhang

Mustieles

Wang

et al. 2023

Environ. Sci. Technol.

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“…Neurodevelopmental impairments presenting during infancy can be secondary to genetic susceptibility, preterm birth, perinatal inflammation, infection, diet, socioeconomic factors, maternal and placental health, and congenital anomalies. Maternal infection with SARS-CoV-2 during pregnancy is associated with preterm birth and inflammation and can lead to mental health problems including anxiety and depression .…”

Section: Discussionmentioning

confidence: 99%

COVID-19 Pandemic and Infant Neurodevelopmental Impairment

et al. 2022

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ImportancePrimary studies proposed that aberrant maternal antiviral immunity and/or giving birth in quarantine, such as during the ongoing COVID-19 pandemic, may be associated with the risk of neurodevelopmental impairment (NDI) in offspring.ObjectivesTo evaluate the associations of birth and being raised during the COVID-19 pandemic with risk of NDI among infants and to assess the association of gestational exposure to SARS-CoV-2 with risk of NDI.Data SourcesPubMed, Web of Science, Scopus, Embase, and preprint servers were systematically searched from inception to March 25, 2022.Study SelectionStudies evaluating the neurodevelopment of infants born during the SARS-CoV-2 pandemic were included in this systematic review and meta-analysis. Studies using Ages and Stages Questionnaires, Third Edition (ASQ-3), were used for quantitative meta-analysis.Data Extraction and SynthesisFollowing the Preferred Reporting Items for Systematic Reviews and Meta-analyses, a random-effects model meta-analysis was used to pool the proportion and odds ratios (ORs) of overall NDI, as well as each developmental domain on ASQ-3 with the corresponding 95% CI.Main Outcomes and MeasuresThe primary outcome was the risk of overall NDI among infants screened during the pandemic vs prepandemic. The secondary outcome was the comparison of NDI by ASQ-3 domain among infants born to women with known gestational exposure to SARS-CoV-2 vs no exposure.ResultsA total of 8 studies were included, including 21 419 infants (11 438 screened in pandemic and 9981 in prepandemic period). NDI was present in 330 of 8992 infants (7%; 95% CI, 4%-10%) screened during the COVID-19 pandemic from January 2020 to January 2021. Among the pandemic cohort, the prevalence of NDI among infants with gestational exposure to SARS-CoV-2 was 77 of 691 (12%; 95% CI, 6%-18%). Compared with the prepandemic cohort (2015-2019), the pandemic cohort was more likely to have communication impairment (OR, 1.70; 95% CI, 1.37-2.11; P &lt; .001), without significant differences in other ASQ-3 domains (eg, gross motor, fine motor, personal-social, and problem-solving). In contrast, maternal SARS-CoV-2 infection was not associated with significant differences in any neurodevelopment domain in offspring, except for increasing the odds of fine motor impairment (OR, 3.46; 95% CI, 1.43-8.38; P &lt; .001).Conclusions and RelevanceIn this systematic review and meta-analysis examining the association between COVID-19 pandemic and the risk of NDI, findings suggest that overall neurodevelopment in the first year of life was not changed by either being born or raised during the SARS-CoV-2 pandemic or by gestational exposure to SARS-CoV-2. Interestingly, the first year of life during the COVID-19 pandemic, regardless of maternal infection, was significantly associated with the risk of communication delay among the offspring.

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“…Some prior work examining maternal dietary factors, for example, has suggested stronger associations between maternal polyunsaturated fatty acid levels and ASD with co-occurring intellectual disability [10,11]. Diet may also interact with other environmental exposures [59], and thus null independent effects do not necessarily imply lack of overall importance, particularly considering evidence for joint effects in key pathways [29].…”

Section: Discussionmentioning

confidence: 99%

Maternal Dietary Patterns during Pregnancy and Child Autism-Related Traits: Results from Two US Cohorts

et al. 2022

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We examined the relationship between maternal intake of established dietary patterns and child autism-related outcomes in two prospective cohorts in the United States. Participants were drawn from the Early Autism Risk Longitudinal Investigation (EARLI, n = 154) and the Nurses’ Health Study II (NHSII, n = 727). Dietary information was collected via food frequency questionnaires (FFQs) and used to calculate the empirical dietary inflammatory pattern (EDIP), Alternative Healthy Eating Index (AHEI), Western and Prudent dietary patterns, and the alternative Mediterranean Diet (aMED) score. Primary analyses examined associations with continuous autism-related traits as measured by the Social Responsiveness Scale (SRS), and secondary analyses with autism spectrum disorder (ASD) diagnosis. We used crude and multivariable quantile regression fixed at the 50th percentile to examine associations between quartiles of dietary patterns and SRS scores, and logistic regression to examine associations with ASD diagnosis. There was suggestion of a positive association with the Western diet (Q4 vs. Q1, ß = 11.19, 95% CI: 3.30, 19.90) in EARLI, though the association was attenuated with adjustment for total energy intake, and no clear associations were observed with other dietary patterns and ASD diagnosis or SRS scores. Further work is needed to better understand the role of maternal dietary patterns in ASD and related outcomes.

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Prenatal Diet as a Modifier of Environmental Risk Factors for Autism and Related Neurodevelopmental Outcomes

Cited by 15 publications

References 78 publications

Red Blood Cell Folate Modifies the Association between Serum Per- and Polyfluoroalkyl Substances and Antibody Concentrations in U.S. Adolescents

Red Blood Cell Folate Modifies the Association between Serum Per- and Polyfluoroalkyl Substances and Antibody Concentrations in U.S. Adolescents

COVID-19 Pandemic and Infant Neurodevelopmental Impairment

Maternal Dietary Patterns during Pregnancy and Child Autism-Related Traits: Results from Two US Cohorts

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