Peer-reviewed article
Association of maternal endometriosis with autism spectrum disorder in offspring: a retrospective cohort study.
Furukawa M, Wada-Hiraike O, Enomoto Y, Tsuchimochi S, Iriyama T et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined whether maternal endometriosis (a chronic inflammation condition) is associated with autism spectrum disorder in children. Using health insurance data from Japan, researchers compared autism diagnoses in children whose mothers had endometriosis with those whose mothers did not. The study found no significant link between maternal endometriosis and autism in offspring, suggesting that maternal endometriosis alone may not be a major risk factor for autism.
Key points
- Among 30,020 mother-child pairs, 3,496 mothers had endometriosis
- Autism was diagnosed in 2.9% of children whose mothers had endometriosis compared to 2.7% of children whose mothers did not
- After adjusting for maternal and peripartum characteristics, no significant association was found (adjusted odds ratio 1.04, 95% CI 0.84-1.29)
- Study suggests children of mothers with endometriosis may not require heightened monitoring specifically for autism risk
Limitations
The study is observational based on insurance database records, so causation cannot be established. The study only measured autism diagnosis at age 3, which may miss cases diagnosed later in childhood.
Abstract
BACKGROUND: With the increasing incidence of autism spectrum disorder (ASD), various risk factors for ASD have been identified. Among them, maternal immune activation (MIA), which can be triggered by inflammation via elevated proinflammatory cytokines, has recently been reported as a risk factor for ASD in offspring. OBJECTIVES: We assessed the association of maternal endometriosis, a chronic gynecological inflammation that may induce MIA, with ASD in offspring. STUDY DESIGN: In this retrospective cohort study, we used the data from a large-scale public health insurance database across Japan to identify dyads of mothers and their firstborn children, delivered between January 2005 and May 2022. Mothers with multiple pregnancies were excluded. The proportions of children diagnosed with ASD at 3 years old were compared between eligible mothers with endometriosis and those without a diagnosis of endometriosis prior to delivery. Multivariable logistic regression analysis was performed to evaluate the association of maternal endometriosis with ASD in children, after adjusting for maternal and peripartum characteristics. RESULTS: We identified 30,020 eligible dyads of mothers and their firstborn children. Among them, 3,496 mothers had endometriosis. The proportions of ASD in the offspring of the group of mothers without and with endometriosis were 2.7% (720/26,524) and 2.9% (102/3,496), respectively. Logistic regression analysis revealed no significant association of maternal endometriosis with ASD in their children (adjusted odds ratio, 1.04; 95% confidence interval, 0.84–1.29). CONCLUSION: No significant association of maternal endometriosis with ASD in offspring was detected in this study. These findings suggest children whose mothers have an antepartum history of endometriosis alone may not need to be closely monitored for ASD, and health care providers or people involved with children may need to consider other reported backgrounds related to ASD.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Identification of maternal endometriosis as a risk factor through retrospective cohort comparison
- Population
- Japanese firstborn children and their mothers, identified from health insurance database, children aged 3 years with autism diagnosis assessment
Key finding
Autism diagnosed in 2.9% (102/3,496) of children with maternal endometriosis versus 2.7% (720/26,524) without maternal endometriosis