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A U.S. study of 224,353 children found that several maternal health conditions during pregnancy were associated with autism diagnoses across racial and ethnic groups. Associations for maternal overweight or obesity, depression, asthma and pregnancy complications were stronger among white mothers; the observational findings do not establish that these conditions cause autism.
A study of 224,353 children born in Northern California found that maternal health conditions during pregnancy were associated with autism diagnoses across racial and ethnic groups, while four associations were stronger among children of white mothers. The findings, reported by Magdalena Janecka and colleagues in JAMA Network Open, describe patterns in health records; they do not show that the conditions caused autism.
The researchers examined children born from 2010 through 2017 in the Kaiser Permanente Northern California health system. Of the children, 5,448 were diagnosed with autism. The mean age at diagnosis was 3 years, and the mean maternal age at delivery was 31.9 years. The analysis assessed 25 maternal diagnoses previously identified as associated with autism.
Most maternal health conditions had similar relationships with autism across the groups studied. The researchers found statistically significant differences by maternal race and ethnicity for four factors: overweight or obesity, depression, asthma and pregnancy complications. Each showed a stronger association with autism among white mothers than among Black, Hispanic, or Asian and Pacific Islander mothers. Two other factors—pain associated with female genital organs and the menstrual cycle, and bipolar disorder—were not significant after adjustment for multiple testing.
Overall, 2.4% of children in the study were diagnosed with autism. The reported prevalence was 3.2% among Black children, 2.9% among Asian and Pacific Islander children, 2.5% among Hispanic children and 2.0% among white children. These are figures from this cohort, not estimates that establish why prevalence differed between groups.
Why the Group Differences Matter
The findings challenge a common approach in which researchers treat a possible risk factor as having the same relationship with autism across all populations. Janecka told MedPage Today that the study aimed to examine how those relationships may vary, rather than averaging them across groups. That matters for interpreting research and for understanding whether health records capture maternal conditions consistently.
The results do not mean that a mother’s race itself causes autism, or that treating a listed condition would prevent a diagnosis. The researchers said the differences could reflect healthcare access, diagnostic practices, or unmeasured environmental and genetic factors. The study identifies patterns that warrant further investigation, not a confirmed explanation for them.
The question also has practical relevance because both maternal conditions and children’s diagnoses were identified through healthcare records. If access to care or diagnosis differs between populations, the records may not represent underlying health conditions in the same way. The study therefore speaks both to autism research and to broader concerns about equity in maternal healthcare.
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How Researchers Studied the Records
Earlier research has reported associations between autism in offspring and several maternal conditions, including obesity, diabetes, hypertensive disorders of pregnancy, asthma and psychiatric conditions such as depression and anxiety. The current study adds a comparison of how a set of 25 diagnoses related to autism across maternal racial and ethnic groups.
The study was retrospective and based on one health system. More than half of mothers in the cohort had two or more of the assessed conditions, and 10.7% had five or more. An accompanying editorial by Aisha Dickerson of the Johns Hopkins Bloomberg School of Public Health emphasized that electronic health records can support large studies but still depend on people having access to healthcare and receiving diagnoses.
Dickerson wrote that the findings support further attention to healthcare disparities and to how researchers study mother-child race and identity. The report also notes that autism’s causes remain unclear. The study concerns associations with maternal health conditions; it does not test a single cause or establish a prevention strategy.
“As advantageous as electronic health records have proven to be for large-scale observational studies, these metrics still require healthcare access.”
— Aisha Dickerson, in an accompanying editorial
What the Associations Cannot Establish
Because the research was observational, it cannot determine whether the maternal conditions caused autism, or explain why the four associations were stronger among white mothers. The authors said differences could involve healthcare access or diagnostic practices, as well as environmental or genetic factors not measured in the analysis. Race and ethnicity comparisons alone cannot distinguish among those explanations.
The authors also acknowledged that the study’s follow-up period was limited, so it may not include children diagnosed at older ages. The findings come from one health system, and the report notes that other dimensions—including insurance status—may affect the patterns. It is not clear from the reported results how much each possible factor contributed.
Further Study of Access and Risk
The results point to a need for research that can test why the associations varied and whether they appear in other populations and healthcare settings. Future studies could examine factors such as insurance status, access to care and diagnostic practices, which Janecka said may shape how maternal conditions are identified. Longer follow-up could also capture autism diagnoses made after the ages covered in this study.
No specific follow-up study or next publication date was provided in the report. For now, the findings should be read as evidence of associations in health records, not as proof of cause or as guidance for individual pregnancy decisions.
Key Questions
Did the study find that maternal health conditions cause autism?
No. It found associations between recorded maternal conditions and children’s autism diagnoses. The observational design cannot establish that the conditions caused autism.
Which associations differed across racial and ethnic groups?
Associations involving maternal overweight or obesity, depression, asthma and pregnancy complications were stronger among white mothers than among Black, Hispanic, or Asian and Pacific Islander mothers.
How large was the study?
The researchers followed 224,353 children born from 2010 through 2017 in Kaiser Permanente Northern California records. A total of 5,448 children in the cohort had an autism diagnosis.
Why might the associations differ between groups?
The study does not settle that question. The authors cited possible differences in healthcare access and diagnostic practices, along with environmental or genetic factors that were not measured.
What are the main limits of the findings?
The study relied on records from one health system, was observational and had a limited follow-up period. It may not include autism diagnoses made at older ages, and recorded diagnoses depend partly on access to healthcare.
Source: rss
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