Examining the relationship between maternal preeclampsia and autism spectrum disorder in childhood.

Objective: Autism spectrum disorder (ASD) has multifactorial origins, some related to the prenatal period. Preeclampsia, a serious pregnancy complication, is also multifactorial. This study aimed to explore the potential association between preeclampsia and ASD in a diverse population.

Study design: A retrospective cohort study including all deliveries of Clalit Health Services-insured women at Soroka University Medical Center from 2005 to 2017. The study compared ASD incidence in offspring of mothers with varying severities of preeclampsia. Kaplan-Meier survival curves assessed cumulative ASD incidence, and Cox proportional hazards models adjusted for confounding factors.

Results: Of 115,081 parturients, 2,856 (2.5%) had preeclampsia, 956 (0.8%) with severe features. Preeclampsia, especially severe, was linked to adverse outcomes (e.g. fetal growth restriction, earlier delivery, cesarean delivery; p < 0.001). Among 767 (0.7%) offspring diagnosed with ASD, prevalence was higher in the preeclampsia group compared to those without preeclampsia (1.1% mild, 0.9% severe, no preeclampsia 0.7%; p = 0.02). However, Kaplan-Meier analysis showed no significant difference in cumulative ASD morbidity (log-rank p = 0.928). Cox regression models, conducted both with and without adjustment for gestational age, showed no significant association between preeclampsia and ASD after adjustment for relevant confounders.

Conclusion: To gain a deeper understanding of the obstetrical aspects related to the development of autism spectrum disorder, our findings indicate that preeclampsia does not play a contributory role.