Food and Behaviour Research

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Maternal metabolic conditions and risk for autism and other neurodevelopmental disorders

Krakowiak P, Walker CK, Bremer AA, Baker AS, Ozonoff S, Hansen RL, Hertz-Picciotto I. (2012) Pediatrics.  129(5) e1121-8. doi: 10.1542/peds.2011-2583. Epub 2012 Apr 9. 

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We examined whether metabolic conditions (MCs) during pregnancy (diabetes, hypertension, and obesity) are associated with autism spectrum disorder (ASD), developmental delays (DD), or impairments in specific domains of development in the offspring.


Children aged 2 to 5 years (517 ASD, 172 DD, and 315 controls) were enrolled in the CHARGE (Childhood Autism Risks from Genetics and the Environment) study, a population-based, case-control investigation between January 2003 and June 2010. Eligible children were born in California, had parents who spoke English or Spanish, and were living with a biological parent in selected regions of California. Children's diagnoses were confirmed by using standardized assessments. Information regarding maternal conditions was ascertained from medical records or structured interview with the mother.


All MCs were more prevalent among case mothers compared with controls. Collectively, these conditions were associated with a higher likelihood of ASD and DD relative to controls (odds ratio: 1.61 (95% confidence interval: 1.10-2.37); odds ratio: 2.35 (95% confidence interval: 1.43-3.88), respectively).

Among ASD cases, children of women with diabetes had Mullen Scales of Early Learning (MSEL) expressive language scores 0.4 SD lower than children of mothers without MCs (P < .01).

Among children without ASD, those exposed to any MC scored lower on all MSEL and Vineland Adaptive Behavior Scales (VABS) subscales and composites by at least 0.4 SD (P < .01 for each subscale/composite).


Maternal MCs may be broadly associated with neurodevelopmental problems in children. With obesity rising steadily, these results appear to raise serious public health concerns.


This retrospective study found increased rates of obesity, diabetes or related metabolic problems during pregnancy in the mothers of children with autism or other developmental disorders of behaviour and learning compared with the mothers of typically developing children.

This study is purely observational, so cannot demonstrate causal effects. However, it adds to increasing evidence from both human and animal studies (which can and do provide evidence of causality) that maternal obesity during pregnancy raises the risks of mental as well as physical health disorders in the resulting offspring.  See also:

Human studies:

Animal studies: