Association between preeclampsia and ASD

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J Child Psychol Psychiatry. 2019 Sep 17. doi: 10.1111/jcpp.13127. [Epub ahead of print]
Association between preeclampsia and autism spectrum disorder: a population-based study.
Maher GM1,2, O'Keeffe GW1,3, Dalman C4,5, Kearney PM2, McCarthy FP1, Kenny LC6, Khashan AS1,2.
Author information

1
INFANT Research Centre, Cork, Ireland.
2
School of Public Health, Western Gateway Building, University College Cork, Cork, Ireland.
3
Department of Anatomy and Neuroscience, Western Gateway Building, University College Cork, Cork, Ireland.
4
Department of Public Health Sciences, Division of Public Health Epidemiology, Karolinska Institutet, Stockholm, Sweden.
5
Center for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden.
6
Department of Women's and Children's Health, Institute of Translational Medicine, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK.

Abstract
BACKGROUND:

The environmental contribution of autism spectrum disorder (ASD) is approximately 17%-50%, highlighting the importance of investigating factors potentially contributing to the likelihood of its development, and of gaining a greater understanding of the pathogenesis surrounding ASD. The objective of this study was to examine the association between preeclampsia and ASD using a population-based cohort study.
METHODS:

All singleton live births in Sweden from 1982 to 2010 were included, using data from Swedish National Registers. Exposures of interest included: (a) preeclampsia (classified according to ICD-8, ICD-9 and ICD-10) and (b) preeclampsia and small for gestational age (SGA) combined, used as a proxy for preeclampsia with placental dysfunction. ASD status was based on ICD-9 and ICD-10. The cohort consisted of 2,842,230 children, with 54,071 cases of ASD. Follow-up began from the child's first birthday, and data were censored at first diagnosis of ASD, death, migration or end of study period (31st December 2016). We conducted multivariate Cox proportional hazards regression analysis, adjusting for several perinatal and sociodemographic factors, selected a priori. We further controlled for shared genetic and familial confounding using sibling-matched analysis.
RESULTS:

In the adjusted Cox proportional hazards regression analysis, preeclampsia was associated with a 25% increase in the likelihood of ASD (Hazard Ratio (HR): 1.25, 95% CI:1.19, 1.30) compared with those unexposed to preeclampsia, while in the sibling-matched analysis the HR was 1.17 (95% CI: 1.06, 1.28). The HR for preeclampsia and SGA combined was 1.66 (95% CI: 1.49, 1.85) in the adjusted Cox model and 1.95 (95% CI: 1.53, 2.48) in the sibling-matched analysis.
CONCLUSIONS:

Exposure to preeclampsia or preeclampsia/SGA (i.e. SGA baby exposed to preeclampsia) was associated with ASD. The stronger association with preeclampsia/SGA than preeclampsia alone suggests that placental pathology may be a mechanism for the increased likelihood of ASD.


https://www.ncbi.nlm.nih.gov/pubmed/31531876

That would actually make sense.

I grew up with a severely autistic boy who had anoxia (oxygen deprivation) at birth.