Table 5.
Joint Effects of Maternal Prepregnancy Obesity, Asthma During Pregnancy, and Gestational Diabetes on Child Neurodevelopmental Outcomes Stratified by Child Sex
| Maternal Condition | No asthma |
Asthma |
p-int | RERI (95% CI) | ||
|---|---|---|---|---|---|---|
| Female |
Male |
Female |
Male |
|||
| OR (95% CI)a | OR (95% CI)a | OR (95% CI)a | OR (95% CI)a | |||
| ASD vs. GP | ||||||
| Not obese | 1.0 (ref) | 1.0 (ref) | 2.54 (1.15–5.61)b | 1.08 (0.64–1.84) | .08 | −1.12 (−4.57 to 2.32) |
| Obese all classes | 1.70 (0.89–3.27) | 1.17 (0.78–1.76) | 5.60 (2.45–12.82)b | 1.75 (0.89–3.45) | .03 | −0.83 (−7.93 to 6.27) |
| Obese class I | 1.74 (0.80–3.76) | 1.10 (0.66–1.83) | 4.53 (1.46–14.05)b | 1.04 (0.37–2.89) | .06 | −3.35 (−10.72 to 4.01) |
| Obese class II | 0.96 (0.21–4.36) | 1.63 (0.83–3.19) | 4.38 (0.82–23.26) | 0.86 (0.25–2.91) | .12 | −4.09 (−13.26 to 5.07) |
| Obese class III | 2.44 (0.76–7.88) | 0.65 (0.23–1.85) | 10.81 (2.66–44.05)b | –c | – | –c |
| DD vs. GP | ||||||
| Not obese | 1.0 (ref) | 1.0 (ref) | 1.68 (1.08–2.60)b | 0.91 (0.62–1.34) | .04 | −0.85 (−1.89 to 0.18) |
| Obese all classes | 1.28 (0.92–1.77) | 1.03 (0.76–1.39) | 1.98 (1.14–3.43)b | 1.36 (0.80–2.33) | .33 | −0.25 (−2.03 to 1.54) |
| Obese class I | 1.26 (0.85–1.87) | 0.91 (0.62–1.32) | 2.28 (1.11–4.70)b | 0.79 (0.37–1.68) | .05 | −1.71 (−3.77 to 0.34) |
| Obese class II | 1.49 (0.81–2.76) | 1.09 (0.64–1.87) | 2.05 (0.73–5.76) | 1.54 (0.70–3.39) | .66 | −0.04 (−3.18 to 3.26) |
| Obese class III | 1.10 (0.54–2.25) | 1.32 (0.71–2.45) | 1.23 (0.35–4.38) | –c | – | –c |
| ASD vs. GP | ||||||
| No GDM | 1.0 (ref) | 1.0 (ref) | 3.00 (1.58–5.70) | 1.38 (0.88–2.16) | .04 | −0.33 (−3.42 to 2.77) |
| GDM | 1.01 (0.36–2.80) | 1.18 (0.70–1.96) | 1.89 (0.36–9.88) | 0.59 (0.19–1.88) | .26 | −2.55 (−7.01 to 1.90) |
| DD vs. GP | ||||||
| No GDM | 1.0 (ref) | 1.0 (ref) | 1.67 (1.15–2.45)b | 1.08 (0.76–1.53) | .09 | −0.53 (−1.48 to 0.42) |
| GDM | 1.46 (0.92–2.30) | 1.48 (1.02–2.15)b | 1.94 (0.81–4.64) | 1.05 (0.52–2.12) | .38 | −0.61 (−2.70 to 1.48) |
| No GDM | GDM | |||||
|---|---|---|---|---|---|---|
| Female |
Male |
Female |
Male |
|||
| OR (95% CI)a | OR (95% CI)a | OR (95% CI)a | OR (95% CI)a | p-int | RERI (95% CI) | |
| ASD vs. GP | ||||||
| Not obese | 1.0 (ref) | 1.0 (ref) | –d | 0.82 (0.43–1.56) | – | – |
| Obese all classes | –d | 1.10 (0.72–1.66) | –d | 1.39 (0.70–2.75) | – | – |
| Obese class I | – d | 0.89 (0.52–1.54) | –d | 1.43 (0.59–3.48) | – | – |
| Obese class II | –d | 1.10 (0.55–2.19) | –d | 1.80 (0.55–5.84) | – | – |
| Obese class III | –d | 2.04 (0.87–4.80) | –d | 0.49 (0.05–4.57) | – | – |
| DD vs. GP | ||||||
| Not obese | 1.0 (ref) | 1.0 (ref) | 1.63 (1.04–2.54)b | 0.90 (0.61–1.32) | .53 | −0.12 (−1.35 to 1.10) |
| Obese all classes | 1.33 (0.95–1.86) | 1.03 (0.76–1.40) | 2.02 (1.16–3.53)b | 1.30 (0.76–2.24) | .72 | 0.69 (−0.93 to 2.32) |
| Obese class I | 1.31 (0.87–1.96) | 0.91 (0.62–1.33) | 2.44 (1.17–5.11)b | 0.73 (0.34–1.59) | .30 | 0.87 (−0.96 to 2.70) |
| Obese class II | 1.57 (0.84–2.93) | 1.05 (0.61–1.82) | 1.94 (0.69–5.47) | 1.49 (0.67–3.32) | .26 | −1.86 (−7.82 to 4.10) |
| Obese class III | 1.15 (0.56–2.36) | 1.30 (0.69–2.45) | 1.28 (0.36–4.59) | –d | – | – |
ASD, autism spectrum disorder; DD, other neurodevelopmental disorders; GDM, gestational diabetes; GP, general population control; OR, odds ratio; RERI, relative excess risk due to interaction.
Adjusted models include child sex, birth year, and maternal age, race, and education. For each combination of maternal conditions, both conditions (i.e., obesity and asthma, GDM and asthma, GDM and obesity) were included in the model simultaneously.
Statistically significant association.
No male GP control participants were exposed to both asthma and obese class III.
Model did not converge due to data sparsity within cells.