CoChat
Sign Up
Cited by 141Autism Spectrum Disorder ResearchGestational Diabetes Research and ManagementBirth, Development, and Health

The DOI matches its Crossref record; 67 of the 67 references it cites were found in a registry or an index.

Maternal body mass index during early pregnancy, gestational weight gain, and risk of autism spectrum disorders: Results from a Swedish total population and discordant sibling study.

Open access
Gardner, Renee M, Lee, Brian K, Magnusson, Cecilia, Rai, Dheeraj, Frisell, Thomas, Karlsson, Håkan, Idring, Selma, Dalman, Christina·2015·International Journal of Epidemiology
DOI 10.1093/ije/dyv081PMC PMC4521130
Open this paper in CoChat — free accountOpen PDF

Abstract

BACKGROUND: Prenatal environmental factors such as maternal adiposity may influence the risk of offspring autism spectrum disorders (ASD), though current evidence is inconsistent. The objective of this study was to assess the relationship of parental BMI and gestational weight gain (GWG) with risk of offspring ASD in a population-based cohort study using family-based study designs. METHODS: The cohort was based in Stockholm County, Sweden, including 333,057 individuals born 1984-2007, of whom 6420 were diagnosed with an ASD. We evaluated maternal body mass index (BMI) at first antenatal visit, GWG and paternal BMI at the time of conscription into the Swedish military as exposures using general estimating equation (GEE) models with logit link. RESULTS: At the population level, maternal overweight/obesity was associated with increased risk of offspring ASD [odds ratio (OR)25 ≤ BMI < 30 1.31, 95% confidence interval = 1.21-1.41; ORBMI ≥ 30 1.94, 1.72-2.17], as was paternal underweight (ORBMI < 18.5, 1.19, 1.06-1.33) and obesity (ORBMI ≥ 30 1.47, 1.12-1.92) in mutually adjusted models. However, in matched sibling analyses, the relationship between elevated maternal BMI and ASD risk was not apparent. GWG had a U-shaped association with offspring ASD at the population level (ORinsufficient 1.22, 1.07-1.40; ORexcessive 1.23, 1.08-1.40). Matched sibling analyses were suggestive of elevated risk with excessive GWG (ORinsufficient 1.12, 0.68-1.84; ORexcessive 1.48, 0.93-2.38). CONCLUSIONS: Whereas population-level results suggested that maternal BMI was associated with ASD, sibling analyses and paternal BMI analyses indicate that maternal BMI may also be a proxy marker for other familial risk factors. Evidence is stronger for a direct link between GWG and ASD risk.

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1093/ije/dyv081

Cites

67 of 67 references verified0 citation errors · 0 not checkable

Statistics

Figures

Figure 1. Derivation of the sample.
Figure 1. Derivation of the sample.CC BY-NC · PubMed Central
Figure 2. The prevalence of overweight and obesity in Swedish women and men over time. (A) Comparison of the prevalence of overweight and obesity among mothers of children in the SYC with other reported values in Swedish women. Berg et al.12 measured weight and height for 605 Swedish women aged 25–34 during the years 1985–2002. Brynhildsen et al.13 collected maternal weight and height at first prenatal visit data from medical records of 4430 women delivering at Swedish hospitals. (B) Prevalence of overweight and obesity among fathers of children in the SYC, based on BMI data collected at the time of conscription into the Swedish military at the age of 18.
Figure 2. The prevalence of overweight and obesity in Swedish women and men over time. (A) Comparison of the prevalence of overweight and obesity among mothers of children in the SYC with other reported values in Swedish women. Berg et al.12 measured weight and height for 605 Swedish women aged 25–34 during the years 1985–2002. Brynhildsen et al.13 collected maternal weight and height at first prenatal visit data from medical records of 4430 women delivering at Swedish hospitals. (B) Prevalence of overweight and obesity among fathers of children in the SYC, based on BMI data collected at the time of conscription into the Swedish military at the age of 18.CC BY-NC · PubMed Central
Figure 3. Risk of ASD in relation to maternal baseline BMI and paternal BMI (age 18). The solid line indicates odds ratios estimated using a restricted cubic spline model with five knots. BMI of 21 was used as the referent value. The 95% confidence interval is represented as grey bands. The model was adjusted for sex, birth year of the child, parity, maternal age, paternal age, maternal country of birth, SES factors and parental history of psychiatric treatment. OR estimates from a categorical model, similarly adjusted, are shown for comparison (dotted line; see Table 2). Results are shown for all ASD cases (A, B), for ASD cases with ID (C, D), and for ASD cases without ID (E, F).
Figure 3. Risk of ASD in relation to maternal baseline BMI and paternal BMI (age 18). The solid line indicates odds ratios estimated using a restricted cubic spline model with five knots. BMI of 21 was used as the referent value. The 95% confidence interval is represented as grey bands. The model was adjusted for sex, birth year of the child, parity, maternal age, paternal age, maternal country of birth, SES factors and parental history of psychiatric treatment. OR estimates from a categorical model, similarly adjusted, are shown for comparison (dotted line; see Table 2). Results are shown for all ASD cases (A, B), for ASD cases with ID (C, D), and for ASD cases without ID (E, F).CC BY-NC · PubMed Central
Figure 4. Risk of offspring ASD associated with maternal gestational weight gain. The solid line indicates odds ratios estimated using a restricted cubic spline model with five knots. A gestational weight gain of 14 kg was used as the referent value. The 95% confidence interval is represented as grey bands. Due to the relatively small sample size for spline analysis, results are shown for weight gain between 7 and 22 kg, representing the 5th to 95th percentiles of the population distribution. (A) Association of maternal GWG with ASD risk among 113 469 mother/child pairs, including adjustment for maternal baseline BMI category. (B) Association of maternal GWG with ASD risk among 84 655 mother/child pairs with normal baseline BMI. OR estimates from a categorical model, similarly adjusted, are shown for comparison (dotted line; see Table 4). (C) Association of maternal GWG with ASD risk among 1156 children in the matched sibling cohort.
Figure 4. Risk of offspring ASD associated with maternal gestational weight gain. The solid line indicates odds ratios estimated using a restricted cubic spline model with five knots. A gestational weight gain of 14 kg was used as the referent value. The 95% confidence interval is represented as grey bands. Due to the relatively small sample size for spline analysis, results are shown for weight gain between 7 and 22 kg, representing the 5th to 95th percentiles of the population distribution. (A) Association of maternal GWG with ASD risk among 113 469 mother/child pairs, including adjustment for maternal baseline BMI category. (B) Association of maternal GWG with ASD risk among 84 655 mother/child pairs with normal baseline BMI. OR estimates from a categorical model, similarly adjusted, are shown for comparison (dotted line; see Table 4). (C) Association of maternal GWG with ASD risk among 1156 children in the matched sibling cohort.CC BY-NC · PubMed Central

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

Show all 67 references

Cited by

Sorted by citations

See all 141

Related

Metadata

Authors
Gardner, R. M., Lee, B. K., Magnusson, C., Rai, D., Frisell, T., Karlsson, H., Idring, S., & Dalman, C.
Affiliations
  • Karolinska Institutet (SE)
  • Drexel University (US)
  • Region Stockholm (SE)
  • Avon and Wiltshire Mental Health Partnership NHS Trust (GB)
Corresponding author
Gardner, Renee M
ORCID
Venue
International Journal of Epidemiology
Publisher
Oxford University Press (OUP)
Published
2015-06
Volume
44
Issue
3
Pages
870-883
ISSN
  • 0300-5771 (ISSN-L)
  • 1464-3685
DOI
10.1093/ije/dyv081
PMC
PMC4521130
OpenAlex
W1902120875
Cited by
141
References
67
Citations by year
2026: 7 · 2025: 10 · 2024: 16 · 2023: 16 · 2022: 7 · 2021: 8 · 2020: 22 · 2019: 14 · 2018: 15 · 2017: 13 · 2016: 12 · 2015: 1
FWCI
8.22
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • International Journal of Epidemiology (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Bristol Research (University of Bristol) (publishedVersion)
Funders
  • Autism Speaks
  • Forskningsrådet för Arbetsliv och Socialvetenskap (2007-2064)
  • Stockholms Läns Landsting (2007008)
  • Vetenskapsrådet (523‐2010‐1052)
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
Keywords
autism spectrum disorder, maternal body mass index, gestational weight gain, maternal obesity, paternal BMI, prenatal environmental exposure, family risk factors
MeSH terms
Autism Spectrum Disorder, Adolescent, Adult, Birth Weight, Child, Child, Preschool, Female, Humans, Male, Obesity, Pregnancy, Pregnancy Complications, Risk Factors, Sweden, Cohort Studies, Weight Gain, Body Mass Index, Odds Ratio, Siblings, Pregnant People, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review