Prenatal maternal stress and the severity of autism spectrum disorder: A cross‐sectional study

Abstract

Autism spectrum disorder (ASD) is a neurodevelopmental disorder linked to several genetic and environmental factors including antenatal stress. Hence, we aimed to examine whether a mother's stress during pregnancy is associated with the severity of autism spectrum disorder in children. The study was conducted with 459 mothers of children with autism (aged 2-14 years) who were attending rehabilitation and educational centers in the two major cities of Makkah and Jeddah in Saudi Arabia.Environmental factors, consanguinity, and ASD family history were assessed using a validated questionnaire. The Prenatal Life Events Scale questionnaire was used to assess whether the mothers were exposed to stress during pregnancy. Two models of ordinal regression analysis were conducted including gender, child age maternal age, parental age, maternal education, parental education, income nicotine exposure, mother taking medication during pregnancy, family history of ASD, gestation, consanguinity, exposure of prenatal life events (in model 1), and severity of prenatal life events (in model 2). Family history of ASD showed a statistically significant association with the severity of ASD in both regression models (p = .015, odds ratio [OR]: 4.261 in Model 1, and p = .014, OR: 4.901 in model 2). In model 2, the moderate severity prenatal life events showed higher statistically significant adjusted odds ratio for ASD severity compared to no stress (p = .031; OR: 3.82). Within the limitations of this study, prenatal stressors showed some potential contribution to ASD severity. Family history of ASD was the only factor that showed a persistent association with ASD severity. A study that assesses the effect of COVID-19 stress on ASD prevalence and severity is recommended.

Family History of Psychological Disorders Moderates the Association Between Prenatal Maternal Stress and Risk of Autism

“…Participants of the study experienced prenatal stress; ASD cases were compered to controls in terms of family history of psychological disorders. Findings of this study in line with previous studies found linkage between prenatal stress and odds of ASD (Ward,1990;Beversdorf et al, 2005;Varcin, et al, 2017;Alamoudi, et al, 2023;Seebeck, Sznajder, & Kjerulff, 2023) .These studies had several limitations include: (1) depending on retrospective recall that may lead to biased information, (2) mothers of children with ASD may frequently experience stressful life events even they are not pregnant, (3) as a result they may expose to stressor in all pregnancies regardless their children have ASD, (4) there were several confounding factors that did not controlled such as problems related to postnatal environments (Kinney, et al, 2008). Present study considered these limitations by using design overcame these difficulties.…”

Prenatal & Perinatal Risk Factors of Autism Spectrum Disorder

“…Result showed that the moderate severity in prenatal life events was associated with ASD than history of no stress(p = .031; OR: 3.82). 13 Similar findings were found in a case control study done by Zhang et al in China. In their study 95 children were taken as case and 95 children as control.…”

“…11 Some studies showed environmental stress, threatened abortion, PET, diabetes, cardiac problem, systemic disease during pregnancy, multiple pregnancy, male child, prolonged labour, preterm birth, low birth weight , neonatal seizure, delayed cry, higher paternal and maternal age at birth as risk factors of ASD. 3,9,[12][13][14][15] Many factors make ASD difficult to understand and manage . Thus, recent research has focused on identifying specific biological abnormalities for diagnostic purposes as well as to measure changes resulting from treatment.…”

A influência de fatores estressores externos na gravidez e suas consequências no desenvolvimento do transtorno do espectro autista

“…Algumas variantes foram refutadas pelos especialistas como responsáveis pelo aumento de autismo, como é o caso da exposição a metais pesados, que não será investigada pelo presente estudo (PORTOLESE et al, 2017). Enquanto isso, outras já foram reconhecidas e comprovadas, como a exposição materna a poluentes, medicamentos usados durante a gravidez, além da idade parental avançada (FRYE et al, 2021;ALAMOUDI et al, 2023). Como exemplo, em estudos de meta-análise, foi demonstrado o aumento do risco em 18 a 21% quando há aumento de 10 anos na idade materna e paterna respectivamente (BEVERSDORF et al, 2018;BEVERSDORF et al, 2005;KINNEY et al, 2007;HECHT et al, 2016;MODABBERNIA;VELTHORST;REICHENBERG, 2017).…”