Skip to main content

Advertisement

Log in

Maternal Infection Requiring Hospitalization During Pregnancy and Autism Spectrum Disorders

  • Original Paper
  • Published:
Journal of Autism and Developmental Disorders Aims and scope Submit manuscript

Abstract

Exposure to prenatal infection has been suggested to cause deficiencies in fetal neurodevelopment. In this study we included all children born in Denmark from 1980, through 2005. Diagnoses of autism spectrum disorders (ASDs) and maternal infection were obtained through nationwide registers. Data was analyzed using Cox proportional hazards regression. No association was found between any maternal infection and diagnosis of ASDs in the child when looking at the total period of pregnancy: adjusted hazard ratio = 1.14 (CI: 0.96–1.34). However, admission to hospital due to maternal viral infection in the first trimester and maternal bacterial infection in the second trimester were found to be associated with diagnosis of ASDs in the offspring, adjusted hazard ratio = 2.98 (CI: 1.29–7.15) and adjusted hazard ratio = 1.42 (CI: 1.08–1.87), respectively. Our results support prior hypotheses concerning early prenatal viral infection increasing the risk of ASDs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Andersen, T. F., Madsen, M., Jorgensen, J., Mellemkjoer, L., & Olsen, J. H. (1999). The Danish national hospital register. A valuable source of data for modern health sciences. Danish Medical Bulletin, 46, 263–268.

    PubMed  Google Scholar 

  • Atladottir, H. O., Parner, E. T., Schendel, D., Dalsgaard, S., Thomsen, P. H., & Thorsen, P. (2007). Variation in incidence of neurodevelopmental disorders with season of birth. Epidemiology, 18, 240–245.

    Article  PubMed  Google Scholar 

  • Autism Developmental Disabilities Monitoring Network. (2009). Prevalence of autism spectrum disorders. Morbidity and Mortality Weekly report (MMWR), 58, 1–20.

    Google Scholar 

  • Barak, Y., Ring, A., Sulkes, J., Gabbay, U., & Elizur, A. (1995). Season of birth and autistic disorder in Israel. American Journal of Psychiatry, 152, 798–800.

    PubMed  Google Scholar 

  • Blaxill, M. F. (2004). What’s going on? The question of time trends in autism. Public Health Reports, 119, 536–551.

    Article  PubMed  Google Scholar 

  • Brown, A. S., Begg, M. D., Gravenstein, S., Schaefer, C. A., Wyatt, R. J., Bresnahan, M., et al. (2004a). Serologic evidence of prenatal influenza in the etiology of schizophrenia. Archives of General Psychiatry, 61, 774–780.

    Article  PubMed  Google Scholar 

  • Brown, A. S., Hooton, J., Schaefer, C. A., Zhang, H., Petkova, E., Babulas, V., et al. (2004b). Elevated maternal interleukin-8 levels and risk of schizophrenia in adult offspring. American Journal of Psychiatry, 161, 889–895.

    Article  PubMed  Google Scholar 

  • Chess, S. (1977). Follow-up report on autism in congenital rubella. Journal of Autism and Childhood Schizophrenia, 7, 69–81.

    Article  PubMed  Google Scholar 

  • Collier, S. A., Rasmussen, S. A., Feldkamp, M. L., & Honein, M. A. (2009). Prevalence of self-reported infection during pregnancy among control mothers in the national birth defects prevention study. Birth Defects Research. Part A, Clinical and Molecular Teratology, 85, 193–201.

    Article  PubMed  Google Scholar 

  • Deykin, E. Y., & MacMahon, B. (1979). Viral exposure and autism. American Journal of Epidemiology, 109, 628–638.

    PubMed  Google Scholar 

  • Djeu, J. Y., Matsushima, K., Oppenheim, J. J., Shiotsuki, K., & Blanchard, D. K. (1990). Functional activation of human neutrophils by recombinant monocyte-derived neutrophil chemotactic factor/IL-8. Journal of Immunology, 144, 2205–2210.

    Google Scholar 

  • Gillberg, C. (1990). Do children with autism have March birthdays? Acta Psychiatrica Scandinavica, 82, 152–156.

    Article  PubMed  Google Scholar 

  • Knudsen, L. B., & Olsen, J. (1998). The Danish medical birth registry. Danish Medical Bulletin, 45, 320–323.

    PubMed  Google Scholar 

  • Landau, E. C., Cicchetti, D. V., Klin, A., & Volkmar, F. R. (1999). Season of birth in autism: A fiction revisited. Journal of Autism and Developmental Disorders, 29, 385–393.

    Article  PubMed  Google Scholar 

  • Lauritsen, M. B., Jorgensen, M., Madsen, K. M., Lemcke, S., Toft, S., Grove, J., et al. (2010). Validity of childhood autism in the Danish psychiatric central register: Findings from a cohort sample born 1990–1999. Journal of Autism and Developmental Disorders, 40, 139–148.

    Article  PubMed  Google Scholar 

  • Libbey, J. E., Sweeten, T. L., McMahon, W. M., & Fujinami, R. S. (2005). Autistic disorder and viral infections. Journal of Neurovirology, 11, 1–10.

    Article  PubMed  Google Scholar 

  • Mosbech, J., Jorgensen, J., Madsen, M., Rostgaard, K., Thornberg, K., & Poulsen, T. D. (1995). The national patient registry. Evaluation of data quality. Ugeskrift for Laeger, 157, 3741–3745.

    PubMed  Google Scholar 

  • Munk-Jorgensen, P., & Mortensen, P. B. (1997). The Danish psychiatric central register. Danish Medical Bulletin, 44, 82–84.

    PubMed  Google Scholar 

  • Nahmias, A. J., Nahmias, S. B., & Danielsson, D. (2006). The possible role of transplacentally-acquired antibodies to infectious agents, with molecular mimicry to nervous system sialic acid epitopes, as causes of neuromental disorders: Prevention and vaccine implications. Clinical & Developmental Immunology, 13, 167–183.

    Article  Google Scholar 

  • Parner, E. T., Schendel, D. E., & Thorsen, P. (2008). Autism prevalence trends over time in Denmark: Changes in prevalence and age at diagnosis. Archives of Pediatrics and Adolescent Medicine, 162, 1150–1156.

    Article  PubMed  Google Scholar 

  • Patterson, P. H. (2009). Immune involvement in schizophrenia and autism: Etiology, pathology and animal models. Behavioural Brain Research, 204(2), 313–321.

    Article  PubMed  Google Scholar 

  • Pedersen, C. B., Gotzsche, H., Moller, J. O., & Mortensen, P. B. (2006). The Danish civil registration system. A cohort of eight million persons. Danish Medical Bulletin, 53, 441–449.

    PubMed  Google Scholar 

  • Ponzio, N. M., Servatius, R., Beck, K., Marzouk, A., & Kreider, T. (2007). Cytokine levels during pregnancy influence immunological profiles and neurobehavioral patterns of the offspring. Annals of the New York Academy of Sciences, 1107, 118–128.

    Article  PubMed  Google Scholar 

  • Shi, L., Fatemi, S. H., Sidwell, R. W., & Patterson, P. H. (2003). Maternal influenza infection causes marked behavioral and pharmacological changes in the offspring. Journal of Neuroscience, 23, 297–302.

    PubMed  Google Scholar 

  • Smith, S. E., Li, J., Garbett, K., Mirnics, K., & Patterson, P. H. (2007). Maternal immune activation alters fetal brain development through interleukin-6. Journal of Neuroscience, 27, 10695–10702.

    Article  PubMed  Google Scholar 

  • Sorensen, H. J., Mortensen, E. L., Reinisch, J. M., & Mednick, S. A. (2009). Association between prenatal exposure to bacterial infection and risk of schizophrenia. Schizophrenia Bulletin, 35(3), 631–637.

    Article  PubMed  Google Scholar 

  • Sweeten, T. L., Posey, D. J., & McDougle, C. J. (2004). Brief report: autistic disorder in three children with cytomegalovirus infection. Journal of Autism and Developmental Disorders, 34, 583–586.

    Article  PubMed  Google Scholar 

  • World Health Organization. (1965). International classification of diseases, Revision 8.

  • World Health Organization. (1993). International classification of diseases, 10th revision.

  • Yamashita, Y., Fujimoto, C., Nakajima, E., Isagai, T., & Matsuishi, T. (2003). Possible association between congenital cytomegalovirus infection and autistic disorder. Journal of Autism and Developmental Disorders, 33, 455–459.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

Funding was provided by the Aarhus University Research Foundation, the Aase and Ejnar Danielsens Foundation, the Augustinus Foundation, and the Familien Hede Nielsens Foundation. The funding sources did not participate in any part of the performance of the study. The authors thank the Aarhus University Hospital, Skejby for their assistance during the validation process.

Disclaimer

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hjördis Ó. Atladóttir.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Atladóttir, H.Ó., Thorsen, P., Østergaard, L. et al. Maternal Infection Requiring Hospitalization During Pregnancy and Autism Spectrum Disorders. J Autism Dev Disord 40, 1423–1430 (2010). https://doi.org/10.1007/s10803-010-1006-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10803-010-1006-y

Keywords

Navigation