Reproductive & Maternal Health Resource Center

Reproductive & Maternal Health Resource Center

Disclosures: The authors report no relevant financial disclosures.
November 25, 2020
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Gestational weight gain associated with increased autism risk for children

Disclosures: The authors report no relevant financial disclosures.
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Pregnancy weight gain in excess of recommendations is associated with a higher risk for autism spectrum disorder among offspring, according to results of a meta-analysis published in Obesity.

“Because autism spectrum disorder (ASD) is estimated to affect approximately 1% of people globally, identifying modifiable risk factors for ASD is of great public health significance,” Ka Kahe, MD, ScD, MPH, the Virgil G. Damon professor of epidemiology and obstetrics and gynecology at Columbia University’s Mailman School of Public Health, and colleagues wrote. “It has been suggested that gaining gestational weight outside the current recommended guidelines may play a critical role in triggering the manifestations of ASD phenotypes in predisposing individuals during the prenatal period. However, existing studies have provided inconsistent evidence.”

Pregnant woman and doctor (Shutterstock)
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In the meta-analysis, researchers considered five cohort studies (n = 4,135) and four case-control studies (cases, n = 1,462; controls, n = 3,265), published before March 19, 2020, assessing associations between gestational weight gain and risk for ASD among children. All but one study used weight status definitions from the 2009 Institute of Medicine guidelines, which were endorsed by the American College of Obstetricians and Gynecologists; the remaining study relied on the 1990 version of the guidelines. Analysis of the cohort studies showed that both excessive (pooled OR = 1.1; 95% CI: 1.02-1.18) and inadequate (pooled OR = 1.13; 95% CI: 1.04-1.24) gestational weight gain were significantly associated with increased autism risk among children compared with recommended amounts of weight gain. Analysis of the case-control studies suggested that only excessive — not inadequate — weight gain during pregnancy (pooled OR = 1.38; 95% CI, 1.19-1.62) was associated with increased autism risk. Researchers noted that associations were not consistently seen across cohort studies and case-control studies.

“Although the underlying mechanisms by which gestational weight gain affects neurodevelopment of offspring are still unclear, it has been suggested that excessive gestational weight gain may induce disturbed blood leptin signaling in offspring, which may consequently lead to adverse neurobiological conditions,” the researchers wrote. “[Inadequate gestational weight gain] may be considered as a marker of suboptimal nutritional status of the fetus, and nutrient deficiencies have been linked to poor neurodevelopment and ASD risk in children.”