Table 3.
Associations Between Maternal Midpregnancy Serum Polyunsaturated Fatty Acid Levels and Offspring Autism Spectrum Disorder in a Population-Based Case-Control Study, California, 2010–2011
| PUFA | Median Value, ng/mL | No. of Cases (n = 499) | No. of Controls (n = 502) | OR a | 95% CI | AOR b | 95% CI | P for Trend c |
|---|---|---|---|---|---|---|---|---|
| ALA (18:3)d | 0.74 | |||||||
| Q1 (lowest) | 0.30 | 109 | 128 | 1.00 | Referent | 1.00 | Referent | |
| Q2 | 0.79 | 132 | 119 | 1.29 | 0.91, 1.84 | 1.26 | 0.87, 1.82 | |
| Q3 | 1.48 | 125 | 125 | 1.18 | 0.82, 1.69 | 1.10 | 0.76, 1.60 | |
| Q4 (highest) | 2.73 | 124 | 122 | 1.21 | 0.83, 1.75 | 1.15 | 0.78, 1.70 | |
| SA (18:4) | 0.96 | |||||||
| Q1 | 0.11 | 90 | 101 | 1.00 | Referent | 1.00 | Referent | |
| Q2 | 0.14 | 138 | 135 | 1.16 | 0.79, 1.69 | 1.08 | 0.73, 1.60 | |
| Q3 | 0.17 | 122 | 115 | 1.21 | 0.81, 1.83 | 1.13 | 0.74, 1.73 | |
| Q4 | 0.22 | 149 | 151 | 1.13 | 0.76, 1.69 | 1.03 | 0.70, 1.56 | |
| EPA (20:5) | 0.86 | |||||||
| Q1 | 0.12 | 107 | 133 | 1.00 | Referent | 1.00 | Referent | |
| Q2 | 0.22 | 136 | 117 | 1.45 | 1.02, 2.08 | 1.28 | 0.88, 1.87 | |
| Q3 | 0.34 | 116 | 130 | 1.12 | 0.78, 1.60 | 0.88 | 0.58, 1.31 | |
| Q4 | 0.71 | 140 | 122 | 1.45 | 1.00, 2.09 | 1.16 | 0.76, 1.77 | |
| DPA (22:5) | 0.73 | |||||||
| Q1 | 9.64 | 125 | 125 | 1.00 | Referent | 1.00 | Referent | |
| Q2 | 13.50 | 120 | 131 | 0.91 | 0.64, 1.30 | 0.81 | 0.56, 1.17 | |
| Q3 | 17.70 | 127 | 123 | 1.03 | 0.72, 1.48 | 0.88 | 0.60, 1.28 | |
| Q4 | 24.50 | 127 | 123 | 1.04 | 0.72, 1.50 | 0.88 | 0.60, 1.30 | |
| DHA (22:6) | ||||||||
| Q1 | 1.05 | 118 | 120 | 1.00 | Referent | 1.00 | Referent | 0.76 |
| Q2 | 1.31 | 132 | 126 | 1.06 | 0.75, 1.51 | 0.96 | 0.67, 1.38 | |
| Q3 | 1.58 | 118 | 136 | 0.88 | 0.61, 1.26 | 0.79 | 0.54, 1.15 | |
| Q4 | 2.11 | 131 | 120 | 1.10 | 0.77, 1.59 | 0.95 | 0.63, 1.43 | |
| LA (18:2) | 0.10 | |||||||
| Q1 | 21.90 | 125 | 124 | 1.00 | Referent | 1.00 | Referent | |
| Q2 | 31.70 | 132 | 120 | 1.08 | 0.76, 1.55 | 0.95 | 0.65, 1.38 | |
| Q3 | 42.00 | 123 | 126 | 0.96 | 0.67, 1.38 | 0.83 | 0.56, 1.22 | |
| Q4 | 58.20 | 119 | 132 | 0.89 | 0.61, 1.28 | 0.74 | 0.49, 1.11 | |
| GLA (18:3)d | 0.75 | |||||||
| Q1 | 1.10 | 121 | 122 | 1.00 | Referent | 1.00 | Referent | |
| Q2 | 1.91 | 118 | 137 | 0.87 | 0.61, 1.24 | 0.82 | 0.57, 1.19 | |
| Q3 | 2.80 | 126 | 123 | 1.02 | 0.71, 1.46 | 0.98 | 0.67, 1.43 | |
| Q4 | 4.45 | 134 | 117 | 1.14 | 0.80, 1.64 | 0.98 | 0.67, 1.44 | |
| DGLA (20:3) | 0.16 | |||||||
| Q1 | 0.93 | 121 | 125 | 1.00 | Referent | 1.00 | Referent | |
| Q2 | 1.42 | 131 | 123 | 1.09 | 0.77, 1.55 | 1.01 | 0.70, 1.45 | |
| Q3 | 1.92 | 126 | 123 | 1.05 | 0.73, 1.51 | 0.88 | 0.60, 1.29 | |
| Q4 | 2.76 | 121 | 131 | 0.94 | 0.65, 1.36 | 0.77 | 0.52, 1.16 | |
| AA (20:4) | 0.90 | |||||||
| Q1 | 4.94 | 118 | 131 | 1.00 | Referent | 1.00 | Referent | |
| Q2 | 5.92 | 123 | 127 | 1.09 | 0.76, 1.56 | 0.96 | 0.66, 1.40 | |
| Q3 | 6.94 | 127 | 123 | 1.17 | 0.81, 1.71 | 0.97 | 0.65, 1.44 | |
| Q4 | 8.44 | 131 | 121 | 1.24 | 0.85, 1.80 | 1.02 | 0.68, 1.51 | |
| Total PUFAse | 0.16 | |||||||
| Q1 | 44.10 | 123 | 125 | 1.00 | Referent | 1.00 | Referent | |
| Q2 | 60.00 | 140 | 126 | 1.12 | 0.79, 1.60 | 1.07 | 0.74, 1.55 | |
| Q3 | 75.40 | 116 | 125 | 0.94 | 0.65, 1.36 | 0.77 | 0.52, 1.15 | |
| Q4 | 101.00 | 120 | 126 | 0.96 | 0.66, 1.40 | 0.81 | 0.54, 1.21 | |
| Total ω-3 PUFAsf | 0.87 | |||||||
| Q1 | 12.30 | 124 | 135 | 1.00 | Referent | 1.00 | Referent | |
| Q2 | 16.70 | 131 | 124 | 0.85 | 0.59, 1.23 | 0.76 | 0.52, 1.11 | |
| Q3 | 21.20 | 119 | 122 | 0.98 | 0.68, 1.41 | 0.83 | 0.57, 1.21 | |
| Q4 | 29.00 | 125 | 121 | 1.06 | 0.73, 1.53 | 0.90 | 0.61, 1.33 | |
| Total ω-6 PUFAsg | 0.18 | |||||||
| Q1 | 30.30 | 124 | 127 | 1.00 | Referent | 1.00 | Referent | |
| Q2 | 42.20 | 142 | 125 | 1.25 | 0.88, 1.79 | 1.11 | 0.77, 1.62 | |
| Q3 | 55.00 | 118 | 125 | 0.91 | 0.63, 1.32 | 0.78 | 0.52, 1.17 | |
| Q4 | 73.50 | 115 | 125 | 0.97 | 0.67, 1.40 | 0.80 | 0.53, 1.20 |
Abbreviations: AA, arachidonic acid; ALA, α-linolenic acid; AOR, adjusted odds ratio; CI, confidence interval; DGLA, dihomo-γ-linolenic acid; DHA, docosahexaenoic acid; DPA, docosapentaenoic acid; EPA, eicosapentaenoic acid; GLA, γ-linolenic acid; LA, linoleic acid; OR, odds ratio; PUFA, polyunsaturated fatty acid; Q, quartile; SA, stearidonic acid.
a Crude OR from a conditional logistic regression model accounting for study matching factors only (sex, birth month, and year of birth).
b Adjusted OR from a conditional logistic regression model including maternal education, maternal race/ethnicity, prepregnancy body mass index, maternal age, health insurance status at delivery, and an indicator for short interpregnancy interval.
c P value from a Wald test for trend across the ordinal score variable for the PUFA, defined using the median value within each quartile.
d Numbers in ALA and GLA quartiles do not sum to the total sample sizes because of the exclusion of 17 samples that failed quality control for ALA and 3 that failed for GLA.
e Sum of all individual PUFAs shown.
f Sum of ALA, SA, EPA, DPA, and DHA.
g Sum of LA, GLA, DGLA, and AA.