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. Author manuscript; available in PMC: 2015 Apr 1.
Published in final edited form as: J Autism Dev Disord. 2014 Apr;44(4):766–775. doi: 10.1007/s10803-013-1928-2

Table 1.

Characteristics of the included studies (n = 12) regarding the association between maternal diabetes and autism spectrum disorders in the offspring

Author, year Country Ethnic
origin
Sample sized Maternal
diabetes criteria
Autism criteria Age of autism
children
Crude risk
estimates (95 %
CI)
Adjusted risk
estimates (95 %
CI)
Matched or adjusted covariates
Case–control studies
Piven et al. (1993) USA N/A 39/39 N/A ADI and ADOS
 (autism)
Mean 14.5 year N/A 3.08
 (0.12–77.91)
Birth ordera
Juul-Dam et al. (2001) USA Mixed 74/? N/A DSM-IV, ADI-R,
 CARS, and ADOS
 (autism and PDD-
 NOS)
Range
 2.5–4 year
3.28 (1.32–8.17) N/A Noneb
Hultman et al. (2002) Sweden Caucasians 408/
 2,040
ICD-8 and ICD-
 9
 (pregestational
 and gestational
 diabetes)
ICD-9 (autism) Mean 4.4 (boy)/
 4.6 (girl)
1.80 (0.60–5.70) 1.20 (0.30–5.70) Sex, year, hospital of birth,
 maternal smoking, pregnancy-
 induced hypertensive diseases,
 and other maternal factors
 (maternal age and parity, and
 mother’s country of birth)
Croen et al. (2005) USA Mixed 407/
 2,095
ICD-9-CM (type
 1 diabetes
 during
 pregnancy)
ICD-9-CM (ASD) Range 3–7 year 2.90(1.00–8.80) 2.60 (0.80–7.90) Sex, birth year, hospital of birth,
 maternal age, maternal
 education, maternal race/
 ethnicity, and plurality
Leonard et al. (2006) Australia N/A 191/
 236,964
ICD-9
 (pregestational
 and gestational
 diabetes)
DSM-IV-R (ASD
 with intellectual
 disability)
Range
 0–16 year
2.89(1.28–6.51) 2.95 (1.30–6.73) Infant sex, birth order, maternal
 ethnicity, age group, marital
 status, height, country of birth,
 health insurance status, and
 paternal occupation, and the
 accessibility/remoteness index of
 Australia
Brimacombe et al. (2007) USA Mixed 164/
 115,542
N/A DSM-IV, CARS, and
 ADOS (ASD)
Mean 6.8 year 1.61 (0.82–3.17) N/A Nonec
Buchmayer et al. (2009) Sweden Caucasians 1,216/
 6,080
ICD-9 and ICD-
 10
 (pregestational
 and gestational
 diabetes)
ICD-9 and ICD-10
 (autistic disorder)
<10 year 1.13 (0.67–1.89) 0.90 (0.49–1.67) Age, gender, birth year, birth
 hospital, maternal age, smoking,
 maternal country of birth,
 whether the mother lived with
 the father, and maternal
 schizophrenia
Elhameed et al. (2011) Egypt N/A 14/28 N/A CARS (autism) Mean 10.9 year 6.33
 (0.24–165.88)
N/A Nonea
Krakowiak et al. (2012) USA Mixed 517/315 N/A ADI-R and ADOS
 (ASD)
Mean 3.65 year 1.51 (0.86–2.74) 1.52 (0.82–2.83) Age, gender, and regional center
 catchment area, mother’s age at
 delivery, race/ethnicity,
 education level, delivery payer,
 calendar time, child’s age at
 enrollment and gender, and
 catchment area
Cohort studies
Burstyn et al. (2010) Canada Mixed 1,138/
 218,890
ICD-9
 (pregestational
 and gestational
 diabetes)
ICD-9 (ASD) 1,998 birth
 cohort: 69 mo
 (boy)/74 mo
 (girl); 2,002
 birth cohort:
 45 mo(boy )/40
 mo (girl)
1.87(1.14–3.06)
 for
 pregestational
 diabetes; 1.41
 (1.07–1.85)
 for gestational
 diabetes
1.65 (1.01–2.71)
 for
 pregestational
 diabetes; 1.24
 (0.94–1.65)
 for gestational
 diabetes
Maternal age, maternal weight,
 maternal height, bleeding,
 cigarette smoking, poor weight
 gain, parity, socioeconomic
 status of mother, presentation,
 type of labour, delivery by
 Caesarian section, gestational
 age, birth weight, Apgar at
 1 min and 5 min, female child,
 and birth year
Dodds et al. (2011) Canada N/A 924/
 129,733
ICD-9 and ICD-
 10
 (pregestational
 and gestational
 diabetes)
ICD-9 (autism, other
 specified PDD), and
 ICD-10 (autism,
 atypical autism,
 Asperger syndrome,
 and unspecified
 PDD)
Range
 0–17 year
1.98 (0.94–4.16)
 for
 pregestational
 diabetes; 1.29
 (0.90–1.83)
 for
 gestational
 diabetes
N/A None
Lyall et al. (2012) USA Mixed 793/
 66,445
N/A ADI-R (ASD) N/A 2.34 (1.80–3.04) 1.76 (1.34–2.32) Race, marital status, income, and
 spouse education, age, age-at-
 first-birth, and parity, twin
 births, pregnancy-related high
 blood pressure, toxemia, induced
 abortions, and miscarriages

ADI-R autism diagnostic interview-revised, ADOS autism diagnostic observation schedule, CARS childhood autism rating scale, DSM-IV-R diagnostic and statistical manual of mental disorders, fourth edition, recommendations, ICD international classification of diseases, PDD pervasive developmental disorders

a

Controls were siblings of the cases

b

Control group was the entire US population

c

Control group was the New Jersey population

d

Sample sizes were incident cases/participants for cohort studies, and cases/controls for case–control studies

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