Association of Maternal Report of Infant and Toddler Gastrointestinal Symptoms With Autism: Evidence From a Prospective Birth Cohort
Open accessAbstract
IMPORTANCE: Gastrointestinal (GI) comorbidities are frequently described in association with autism spectrum disorder (ASD). However, the prevalence of GI disturbances and the age at which such problems first appear are unclear, and their specificity for ASD compared with other neurodevelopmental disorders is uncertain. OBJECTIVE: To compare maternal report of GI symptoms during the first 3 years of life in children with ASD, developmental delay (DD), and typical development (TD). DESIGN, SETTING, AND PARTICIPANTS: This large prospective cohort study consists of participants in the Norwegian Mother and Child Cohort Study. During a 10-year period (January 1, 1999, through December 31, 2008), women throughout Norway were recruited at the first prenatal ultrasonographic visit (approximately 18 weeks' gestation). The study enrolled 95,278 mothers, 75,248 fathers, and 114,516 children. Our analyses are based on MoBa data released through October 1, 2013, and NPR diagnoses registered through December 31, 2012, and include children born from January 1, 2002, through December 31, 2008, with completed age 18- and 36-month questionnaires. EXPOSURES: We defined 3 groups of children: children with ASD (n = 195), children with DD and delayed language and/or motor development (n = 4636), and children with TD (n = 40 ,95). MAIN OUTCOMES AND MEASURES: The GI symptoms were based on maternal report of constipation, diarrhea, and food allergy/intolerance. RESULTS: Children with ASD were at significantly increased odds of maternally reported constipation (adjusted odds ratio [aOR], 2.7; 95% CI, 1.9-3.8; P < .001) and food allergy/intolerance (aOR, 1.7; 95% CI, 1.1-2.6; P = .01) in the 6- to 18-month-old age period and diarrhea (aOR, 2.3; 95% CI, 1.5-3.6; P < .001), constipation (aOR, 1.6; 95% CI, 1.2-2.3; P < .01), and food allergy/intolerance (aOR, 2.0; 95% CI, 1.3-3.1; P < .01) in the 18- to 36-month-old age period compared with children with TD. Similar results for these symptom categories were observed in comparisons with children with DD, but ORs were slightly lower. Mothers of children with ASD were significantly more likely to report 1 or more GI symptom in either the 6- to 18-month or the 18- to 36-month-old age period and more than twice as likely to report at least 1 GI symptom in both age periods compared with mothers of children with TD or DD. CONCLUSIONS AND RELEVANCE: In this large prospective cohort, maternally reported GI symptoms are more common and more often persistent during the first 3 years of life in children with ASD than in children with TD or DD.
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GI symptoms are more common in toddlers with ASD than in children with typical development or other developmental delays.
“GI symptoms are also more common in toddlers with ASD than children with typical development or other developmental delays 13”
From Gastrointestinal Issues and Autism Spectrum Disorder (2020) · cites this paper as [13]
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Cites
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,841 · see citing works
Statistical Methods for Rates and Proportions
Fleiss, J. L., Levin, B., & Paik, M. C. (2003) · Wiley Series in Probability and Statistics · doi:10.1002/0471445428 · Cited by 18,646 · see citing works
Lord, C., Rutter, M., & Le Couteur, A. (1994) · Journal of Autism and Developmental Disorders · doi:10.1007/bf02172145 · Cited by 9,065 · see citing works
Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Leventhal, B. L., DiLavore, P. C., Pickles, A., & Rutter, M. (2000) · Journal of Autism and Developmental Disorders · doi:10.1023/a:1005592401947 · Cited by 7,520 · see citing works
Gershon, M. D., & Tack, J. (2007) · Gastroenterology · doi:10.1053/j.gastro.2006.11.002 · Cited by 1,563 · see citing works
The developmental role of serotonin: news from mouse molecular genetics
Gaspar, P., Cases, O., & Maroteaux, L. (2003) · Nature Reviews Neuroscience · doi:10.1038/nrn1256 · Cited by 1,297 · see citing works
Cohort profile: The Norwegian Mother and Child Cohort Study (MoBa)
Magnus, P. M., Irgens, L. M., Haug, K., Nystad, W., Skjærven, R., & Stoltenberg, C. (2006) · International Journal of Epidemiology · doi:10.1093/ije/dyl170 · Cited by 1,027 · see citing works
Self-citationBuie, T., Campbell, D. B., Fuchs, G. J., Furuta, G. T., Levy, J., VandeWater, J., Whitaker, A. H., Atkins, D., Bauman, M. L., Beaudet, A. L., et al. (2010) · Pediatrics · doi:10.1542/peds.2009-1878c · Cited by 872 · see citing works
The role of immune dysfunction in the pathophysiology of autism
Onore, C., Careaga, M., & Ashwood, P. (2012) · Brain, Behavior, and Immunity · doi:10.1016/j.bbi.2011.08.007 · Cited by 635 · see citing works
Revision of a Parent-Completed Developmental Screening Tool: Ages and Stages Questionnaires
Squires, J., Bricker, D. D., & Potter, L. (1997) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/22.3.313 · Cited by 601 · see citing works
Gastrointestinal Problems in Children with Autism, Developmental Delays or Typical Development
Chaidez, V., Hansen, R. L., & Hertz-Picciotto, I. (2014) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-013-1973-x · Cited by 528 · see citing works
Williams, B. L., Hornig, M., Buie, T., Bauman, M. L., Cho Paik, M., Wick, I., Bennett, A., Jabado, O., Hirschberg, D. L., & Lipkin, W. I. (2011) · PLoS ONE · doi:10.1371/journal.pone.0024585 · Cited by 492 · see citing works
Self-citationNelson, H. D., Nygren, P., Walker, M., & Panoscha, R. (2006) · Pediatrics · doi:10.1542/peds.2005-1467 · Cited by 427 · see citing works
A genetic variant that disrupts <i>MET</i> transcription is associated with autism
Campbell, D. B., Sutcliffe, J. S., Ebert, P. J., Militerni, R., Bravaccio, C., Trillo, S., Elia, M., Schneider, C., Melmed, R., Sacco, R., et al. (2006) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.0605296103 · Cited by 401 · see citing works
Medical Comorbidities in Autism: Challenges to Diagnosis and Treatment
Bauman, M. L. (2010) · Neurotherapeutics · doi:10.1016/j.nurt.2010.06.001 · Cited by 372 · see citing works
Feeding Symptoms, Dietary Patterns, and Growth in Young Children With Autism Spectrum Disorders
Emond, A., Emmett, P., Steer, C., & Golding, J. (2010) · Pediatrics · doi:10.1542/peds.2009-2391 · Cited by 338 · see citing works
Gastrointestinal dysfunction in autism: parental report, clinical evaluation, and associated factors
Gorrindo, P., Williams, K. C., Lee, E. B., Walker, L. S., McGrew, S. G., & Levitt, P. (2012) · Autism Research · doi:10.1002/aur.237 · Cited by 325 · see citing works
Incidence of Gastrointestinal Symptoms in Children With Autism: A Population-Based Study
Ibrahim, S. H., Voigt, R. G., Katusic, S. K., Weaver, A. L., & Barbaresi, W. J. (2009) · PEDIATRICS · doi:10.1542/peds.2008-2933 · Cited by 298 · see citing works
Folic Acid Supplements in Pregnancy and Severe Language Delay in Children
Roth, C., Magnus, P. M., Schjølberg, S., Stoltenberg, C., Surén, P., McKeague, I. W., Smith, G. D., Reichborn‐Kjennerud, T., & Susser, E. (2011) · JAMA · doi:10.1001/jama.2011.1433 · Cited by 266 · see citing works
Self-citationGastrointestinal Conditions in Children With Autism Spectrum Disorder: Developing a Research Agenda
Coury, D. L., Ashwood, P., Fasano, A., Fuchs, G., Geraghty, M., Kaul, A., Mawe, G., Patterson, P., & Jones, N. E. (2012) · Pediatrics · doi:10.1542/peds.2012-0900n · Cited by 264 · see citing works
Chandana, S. R., Behen, M. E., Juhász, C., Muzik, O., Rothermel, R. D., Mangner, T. J., Chakraborty, P. K., Chugani, H. T., & Chugani, D. C. (2004) · International Journal of Developmental Neuroscience · doi:10.1016/j.ijdevneu.2004.08.002 · Cited by 233 · see citing works
Leboyer, M., Philippe, A., Bouvard, M., Guilloud-Bataille, M., Bondoux, D., Tabuteau, F., Feingold, J., Mouren-Simeoni, M.-C., & Launay, J.-M. (1999) · Biological Psychiatry · doi:10.1016/s0006-3223(97)00532-5 · Cited by 194 · see citing works
Campbell, D. B., Li, C., Sutcliffe, J. S., Persico, A. M., & Levitt, P. (2008) · Autism Research · doi:10.1002/aur.27 · Cited by 154 · see citing works
Campbell, D. B., Buie, T. M., Winter, H., Bauman, M., Sutcliffe, J. S., Perrin, J. M., & Levitt, P. (2009) · Pediatrics · doi:10.1542/peds.2008-0819 · Cited by 145 · see citing works
The role of microbes and autoimmunity in the pathogenesis of neuropsychiatric illness
Hornig, M. (2013) · Current Opinion in Rheumatology · doi:10.1097/bor.0b013e32836208de · Cited by 138 · see citing works
Self-citationParental Obesity and Risk of Autism Spectrum Disorder
Surén, P., Gunnes, N., Roth, C., Bresnahan, M. A., Hornig, M., Hirtz, D., Lie, K. K., Lipkin, W. I., Magnus, P. M., Reichborn-Kjennerud, T., et al. (2014) · PEDIATRICS · doi:10.1542/peds.2013-3664 · Cited by 134 · see citing works
Self-citationGastrostomy feeding in cerebral palsy: a systematic review.
Sleigh, G., & Brocklehurst, P. (2004) · PubMed · Cited by 132 · see citing works
Levy, S. E., Souders, M. C., Ittenbach, R. F., Giarelli, E., Mulberg, A. E., & Pinto-Martin, J. A. (2007) · Biological Psychiatry · doi:10.1016/j.biopsych.2006.07.013 · Cited by 130 · see citing works
Eggesbø, M. Å., Botten, G., Halvorsen, R., & Magnus, P. M. (2001) · Allergy · doi:10.1034/j.1398-9995.2001.056005393.x · Cited by 122 · see citing works
Self-citationThe Autism Birth Cohort: a paradigm for gene–environment–timing research
Stoltenberg, C., Schjølberg, S., Bresnahan, M., Hornig, M., Hirtz, D., Dahl, C., Lie, K. K., Reichborn-Kjennerud, T., Schreuder, P., Alsaker, E., et al. (2010) · Molecular Psychiatry · doi:10.1038/mp.2009.143 · Cited by 119 · see citing works
Self-citationMotil, K. J., Schultz, R., Browning, K., et al. (1999) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/00005176-199907000-00010 · Cited by 104 · see citing works
Singh, V. K., Singh, E. A., & Warren, R. P. (1997) · Biological Psychiatry · doi:10.1016/s0006-3223(96)00522-7 · Cited by 99 · see citing works
Parent-Reported Gastro-intestinal Symptoms in Children with Autism Spectrum Disorders
Chandler, S., Carcani-Rathwell, I., Charman, T., Pickles, A. R., Loucas, T., Meldrum, D., Simonoff, E. A., Sullivan, P. B., & Baird, G. (2013) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-013-1768-0 · Cited by 78 · see citing works
Veldhuizen, S., Clinton, J. M., Rodriguez, C., et al. (2014) · Academic Pediatrics · doi:10.1016/j.acap.2014.08.002 · Cited by 69 · see citing works
Jackson, P. B., Boccuto, L., Skinner, C., Collins, J. S., Neri, G., Gurrieri, F., & Schwartz, C. E. (2009) · Autism Research · doi:10.1002/aur.87 · Cited by 65 · see citing works
The nervous system and gastrointestinal function
Altaf, M. A., & Sood, M. R. (2008) · Developmental Disabilities Research Reviews · doi:10.1002/ddrr.15 · Cited by 53 · see citing works
Mouridsen, S. E., Rich, B., & Isager, T. (2010) · Child Care Health and Development · doi:10.1111/j.1365-2214.2009.01021.x · Cited by 31 · see citing works
The early stool patterns of young children with autistic spectrum disorder
Sandhu, B., Steer, C. D., Golding, J., & Emond, A. M. (2009) · Archives of Disease in Childhood · doi:10.1136/adc.2008.148866 · Cited by 28 · see citing works
Replication of the Association of a MET Variant with Autism in a Chinese Han Population
Zhou, X., Xu, Y., Wang, J., Zhou, H.-B., Liu, X., Ayub, Q., Wang, X.-L., Tyler-Smith, C., Wu, L.-J., & Xue, Y.-L. (2011) · PLoS ONE · doi:10.1371/journal.pone.0027428 · Cited by 24 · see citing works
Dale (2003) · Oxford University Research Archive (ORA) (University of Oxford) · doi:10.1044/1092-4388(2003/044 · Cited by 21 · see citing works
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Research works printed but not linked: 1
- [21]Sparrow SS Cicchetti DV Balla DA Vineland Adaptive Behavior Scales: Second Edition (Vineland II), Survey Interview Form/Caregiver Rating Form Livonia, MI Pearson Assessments 2005
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Identification, Evaluation, and Management of Children With Autism Spectrum Disorder
Hyman, S. L., Levy, S. E., Myers, S. M., COUNCIL ON CHILDREN WITH DISABILITIES, S. O. D. A. B. P., Kuo, D. Z., Apkon, S., Davidson, L. F., Ellerbeck, K. A., Foster, J. E. A., Noritz, G. H., et al. (2020) · Pediatrics · doi:10.1542/peds.2019-3447 · Cited by 1,548 · see citing works
Microbial reconstitution reverses maternal diet-induced social and synaptic deficits in offspring
Buffington, S. A., Di Prisco, G. V., Auchtung, T. A., Ajami, N. J., Petrosino, J. F., & Costa-Mattioli, M. (2016) · Cell · doi:10.1016/j.cell.2016.06.001 · Cited by 1,163 · see citing works
Holingue, C., Newill, C., Lee, L., Pasricha, P. J., & Daniele Fallin, M. (2018) · Autism Research · doi:10.1002/aur.1854 · Cited by 296 · see citing works
Prenatal fever and autism risk
Hornig, M., Bresnahan, M. A., Che, X., Schultz, A. F., Ukaigwe, J. E., Eddy, M. L., Hirtz, D., Gunnes, N., Lie, K. K., Magnus, P., et al. (2018) · Molecular Psychiatry · doi:10.1038/mp.2017.119 · Cited by 222 · see citing works
Self-citationSantocchi, E., Guiducci, L., Fulceri, F., Billeci, L., Buzzigoli, E., Apicella, F., Calderoni, S., Grossi, E., Morales, M. A., & Muratori, F. (2016) · BMC Psychiatry · doi:10.1186/s12888-016-0887-5 · Cited by 213 · see citing works
Gastrointestinal symptoms and behavioral problems in preschoolers with Autism Spectrum Disorder
Fulceri, F., Morelli, M., Santocchi, E., Cena, H., Del Bianco, T., Narzisi, A., Calderoni, S., & Muratori, F. (2016) · Digestive and Liver Disease · doi:10.1016/j.dld.2015.11.026 · Cited by 191 · see citing works
Gastrointestinal Issues and Autism Spectrum Disorder
Madra, M., Ringel, R., & Margolis, K. G. (2020) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2020.02.005 · Cited by 159 · see citing works
Microbiome and nutrition in autism spectrum disorder: Current knowledge and research needs
Berding, K., & Donovan, S. M. (2016) · Nutrition Reviews · doi:10.1093/nutrit/nuw048 · Cited by 146 · see citing works
<scp>O</scp>xytocin modulation of neural circuits for social behavior
Marlin, B. J., & Froemke, R. C. (2017) · Developmental Neurobiology · doi:10.1002/dneu.22452 · Cited by 130 · see citing works
Lefter, R., Ciobica, A., Timofte, D., Stanciu, C., & Trifan, A. (2019) · Medicina · doi:10.3390/medicina56010011 · Cited by 120 · see citing works
Detection of Clostridium perfringens toxin genes in the gut microbiota of autistic children
Finegold, S. M., Summanen, P. H., Downes, J., Corbett, K., & Komoriya, T. (2017) · Anaerobe · doi:10.1016/j.anaerobe.2017.02.008 · Cited by 110 · see citing works
Gastrointestinal involvement of autism spectrum disorder: focus on gut microbiota
Settanni, C. R., Bibbò, S., Ianiro, G., Rinninella, E., Cintoni, M., Mele, M. C., Cammarota, G., & Gasbarrini, A. (2021) · Expert Review of Gastroenterology & Hepatology · doi:10.1080/17474124.2021.1869938 · Cited by 98 · see citing works
Frye, R. E., & Rossignol, D. A. (2016) · Clinical Medicine Insights Pediatrics · doi:10.4137/cmped.s38337 · Cited by 96 · see citing works
Psychophysiological associations with gastrointestinal symptomatology in autism spectrum disorder
Ferguson, B. J., Marler, S., Altstein, L. L., Lee, E. B., Akers, J., Sohl, K., McLaughlin, A., Hartnett, K., Kille, B., Mazurek, M., et al. (2017) · Autism Research · doi:10.1002/aur.1646 · Cited by 84 · see citing works
Rose, S., Bennuri, S. C., Murray, K. F., Buie, T., Winter, H., & Frye, R. E. (2017) · PLOS ONE · doi:10.1371/journal.pone.0186377 · Cited by 82 · see citing works
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Plaza-Diaz, J., Flores-Rojas, K., Torre-Aguilar, M. J. D. L., Gomez-Fernández, A. R., Martín-Borreguero, P., Perez-Navero, J. L., Gil, A., & Gil-Campos, M. (2021) · Nutrients · doi:10.3390/nu13103551 · Cited by 56 · see citing works
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Ferguson, B. J., Dovgan, K., Severns, D., Martin, S., Marler, S., Gross Margolis, K., Bauman, M. L., Veenstra-VanderWeele, J., Sohl, K., & Beversdorf, D. Q. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00528 · Cited by 20 · see citing works
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- Authors
- Bresnahan, M., Hornig, M., Schultz, A. F., Gunnes, N., Hirtz, D., Lie, K. K., Magnus, P., Reichborn-Kjennerud, T., Roth, C., Schjølberg, S., Stoltenberg, C., Surén, P., Susser, E., & Lipkin, W. I.
- Affiliations
- New York State Psychiatric Institute (US)
- Columbia University (US)
- Norwegian Institute of Public Health (NO)
- National Institute of Neurological Disorders and Stroke (US)
- Norwegian Institute of Public Health, Oslo, Norway6Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Corresponding author
- Bresnahan, Michaeline
- Venue
- JAMA Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 2015-05-01
- Volume
- 72
- Issue
- 5
- Pages
- 466
- ISSN
- 2168-622X (ISSN-L)
- PMC
- PMC4939710
- OpenAlex
- W2054676430
- Cited by
- 132
- References
- 40
- Citations by year
- 2026: 7 · 2025: 10 · 2024: 12 · 2023: 14 · 2022: 9 · 2021: 16 · 2020: 15 · 2019: 16 · 2018: 5 · 2017: 11 · 2016: 14 · 2015: 2
- FWCI
- 6.41
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- JAMA Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Neurological Disorders and Stroke (U01NS047537, NS47537)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Keywords
- autism spectrum disorder, gastrointestinal symptoms, constipation, diarrhea, food allergy, food intolerance, developmental delay, maternal report, neurodevelopmental disorders, MoBa cohort, Norwegian Mother and Child Cohort Study, age of onset, diagnostic specificity, typical development, screening thresholds
- MeSH terms
- Adult, Child Development, Developmental Disabilities, Child Development Disorders, Pervasive, Child, Preschool, Constipation, Diarrhea, Female, Food Hypersensitivity, Humans, Infant, Male, Mothers, Norway, Prospective Studies, Surveys and Questionnaires, Prevalence, Evidence-Based Medicine
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