Pregnancy Planning and its Association with Autism Spectrum Disorder: Findings from the Study to Explore Early Development.

AUTISM risk factors; ATTITUDES toward pregnancy; FAMILY planning; RISK assessment; SELF-evaluation; SECONDARY analysis; STATISTICAL sampling; AUTISM; LOGISTIC regression analysis; QUESTIONNAIRES; DESCRIPTIVE statistics; ATTITUDES of mothers; PREGNANCY outcomes; DEVELOPMENTAL disabilities; ODDS ratio; RACE; RESEARCH; PSYCHOLOGY of mothers; CONFIDENCE intervals; DISEASE risk factors; SYMPTOMS; CHILDREN

MARYLAND; NORTH Carolina; PENNSYLVANIA; CALIFORNIA; GEORGIA; COLORADO

Objectives: To examine associations between pregnancy planning and autism spectrum disorder (ASD) in offspring. Methods: The Study to Explore Early Development (SEED), a multi-site case-control study, enrolled preschool-aged children with ASD, other DDs, and from the general population (POP). Some children with DDs had ASD symptoms but did not meet the ASD case definition. We examined associations between mother's report of trying to get pregnant (pregnancy planning) and (1) ASD and (2) ASD symptomatology (ASD group, plus DD with ASD symptoms group combined) (each vs. POP group). We computed odds ratios adjusted for demographic, maternal, health, and perinatal health factors (aORs) via logistic regression. Due to differential associations by race-ethnicity, final analyses were stratified by race-ethnicity. Results: Pregnancy planning was reported by 66.4%, 64.8%, and 76.6% of non-Hispanic White (NHW) mothers in the ASD, ASD symptomatology, and POP groups, respectively. Among NHW mother-child pairs, pregnancy planning was inversely associated with ASD (aOR = 0.71 [95% confidence interval 0.56–0.91]) and ASD symptomatology (aOR = 0.67 [0.54–0.84]). Pregnancy planning was much less common among non-Hispanic Black mothers (28-32% depending on study group) and Hispanic mothers (49-56%) and was not associated with ASD or ASD symptomatology in these two race-ethnicity groups. Conclusion: Pregnancy planning was inversely associated with ASD and ASD symptomatology in NHW mother-child pairs. The findings were not explained by several adverse maternal or perinatal health factors. The associations observed in NHW mother-child pairs did not extend to other race-ethnicity groups, for whom pregnancy planning was lower overall. Significance: What is Already Known on this Subject?: Almost half of all the pregnancies in the U.S. are unintended and unintended pregnancy has been associated with adverse birth outcomes. What this Study adds?: Among non-Hispanic white mother-child pairs, pregnancy planning was inversely associated with autism spectrum disorder (ASD) and ASD symptomatology. This association was not seen for non-Hispanic Black and Hispanic mother-child pairs, for whom pregnancy planning was lower overall. [ABSTRACT FROM AUTHOR]