Preeclampsia during pregnancy was associated with autism spectrum disorder (ASD) in a study published online ahead of print in JAMA Pediatrics.

Cheryl Walker, MD, and fellow investigators evaluated data from 517 boys and girls with autism, 194 with developmental delay, and 350 controls who were developing typically. The children, aged 2 and 3 years, were enrolled in the Childhood Autism Risks from Genetics and the Environment (CHARGE) study. All the mothers of these children had a confirmed diagnosis of preeclampsia during pregnancy.

Walker’s group found that children with ASD were more than twice as likely to have been exposed in utero to preeclampsia. Placental insufficiency, severe preeclampsia, or both of these conditions were more likely to have occurred in the mothers of children with autism and mothers of children with developmental delay, compared with mothers of children who were developing typically.

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The researchers also found that a diagnosis of autism was more likely if the mother had had a more severe case of preeclampsia.

Women with preeclampsia experience hypertension during the latter half of the pregnancy and may have increased levels of proteinuria and edema, noted the authors in a press release from the University of California-Davis (UC-Davis), with which they are affiliated.

For the fetus, they stated, limitations in nutrient and oxygen availability cause progressive oxidative stress that prompt the release of proteins into the maternal bloodstream in an effort to improve circulation. 

“It appears that it’s primarily with severe disease that this happens, and even with that, the vast majority of women with severe preeclampsia don’t have children who develop autism,” Walker explained in an interview accessed through the UC-Davis press release.

“So the important thing is for the woman and her family and her obstetrician to work together to see whether or not the disease is progressing at a stage that is hampering the baby’s development.”