Table 4.
Incidence of Autism Spectrum Disorder (ASD) with neurodevelopmental comorbidities starting at 1 year of age according to defective placentation syndromes. Live-born singleton non-malformed children in Sweden 2000–2016.
| Defective placentation syndrome | ASD with intellectual disability n = 1,625,079 |
ASD with ADHD n = 1,631,233 |
ASD with epilepsy n = 1,623,077 |
ASD alone n = 1,621,645 |
||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| No. with ASD | Rate per 10,000 child-y | Adjusted hazard ratio (95% CI)1,2 | No. with ASD | Rate per 10,000 child-y | Adjusted hazard ratio (95% CI)1,3 | No. with ASD | Rate per 10,000 child-y | Adjusted hazard ratio (95% CI)1,4 | No. with ASD | Rate per 10,000 child-y | Adjusted hazard ratio (95% CI)1,5 | |
|
| ||||||||||||
| Total | 3434 | 2.36 | 9588 | 6.56 | 1432 | 0.99 | 11,357 | 7.77 | ||||
| Placental abruption | ||||||||||||
| No | 3413 | 2.36 | 1.00 | 9541 | 6.55 | 1.00 | 1425 | 0.98 | 1.00 | 11,298 | 7.76 | 1.00 |
| Yes | 21 | 4.35 | 1.74 (1.09, 2.77) | 47 | 9.68 | 1.26 (0.92, 1.72) | 7 | 1.45 | 1.71 (0.81, 3.60) | 59 | 12.15 | 1.42 (1.07, 1.89) |
| Preeclampsia | ||||||||||||
| No preeclampsia | 3281 | 2.32 | 1.00 | 9181 | 6.46 | 1.00 | 1380 | 0.98 | 1.00 | 10,937 | 7.69 | 1.00 |
| Preeclampsia at ≥37 weeks without SGA6 | 72 | 2.70 | 1.05 (0.81, 1.36) | 239 | 8.89 | 1.09 (0.95, 1.26) | 23 | 0.86 | 0.68 (0.42, 1.09) | 259 | 9.64 | 1.08 (0.94, 1.23) |
| Preeclampsia at ≥37 weeks with SGA | 25 | 5.78 | 1.80 (1.13, 2.87) | 51 | 11.70 | 1.55 (1.15, 2.07) | 10 | 2.32 | 2.16 (1.12, 4.18) | 56 | 12.89 | 1.43 (1.08, 1.89) |
| Preeclampsia at 34 to 36 weeks | 24 | 4.70 | 1.96 (1.27, 3.01) | 62 | 12.04 | 1.56 (1.19, 2.06) | 6 | 1.18 | 1.30 (0.58, 2.90) | 59 | 11.48 | 1.34 (1.02, 1.77) |
| Preeclampsia at <34 weeks | 31 | 9.81 | 2.30 (1.40, 3.76) | 54 | 16.92 | 1.69 (1.20, 2.38) | 13 | 4.13 | 3.49 (1.86, 6.52) | 45 | 14.15 | 1.66 (1.21, 2.28) |
| Missing | 1 | 7.96 | 1 | 7.96 | 0 | 1 | 7.97 | |||||
| Gestational age7 | ||||||||||||
| Term | 3107 | 2.24 | 1.00 | 8945 | 6.42 | 1.00 | 1305 | 0.94 | 1.00 | 10,648 | 7.64 | 1.00 |
| Preterm spontaneous | 195 | 4.11 | 1.57 (1.33, 1.85) | 389 | 8.16 | 1.12 (1.00, 1.25) | 81 | 1.71 | 1.59 (1.23, 2.05) | 458 | 9.61 | 1.13 (1.02, 1.26) |
| Preterm medically indicated | 117 | 6.69 | 2.06 (1.62, 2.62) | 216 | 12.26 | 1.41 (1.20, 1.67) | 40 | 2.29 | 2.13 (1.47, 3.08) | 224 | 12.73 | 1.45 (1.24, 1.69) |
| Missing | 15 | 6.91 | 38 | 17.23 | 6 | 2.77 | 27 | 12.34 | ||||
Estimates are from proportional hazards models with age at first diagnosis of autism as the outcome and each placentation disorder as the exposure, adjusted for maternal age, country of origin, cohabitation with the child’s father, education level, parity, height, early-pregnancy body mass index, smoking during pregnancy, presence of a diagnosis of ASD in the mother or the father, maternal polycystic ovarian syndrome, and infant sex and year of birth. Estimates for type of preterm birth were further adjusted for preeclampsia and SGA. A robust estimate of the variance was specified in all models to account for siblings. The comparison group for each diagnosis comprises children without ASD.
Complete case analysis; n = 1,447,172 with 2949 cases of ASD.
Complete case analysis; n = 1,455,355 with 8183 cases of ASD.
Complete case analysis; n = 1,447,172 with 1203 cases of ASD
Complete case analysis; n = 1,457,042 with 9870 cases of ASD.
Birth weight-for-gestational age <10th percentile.
Term: ≥37 weeks. Preterm: ≤ 36 weeks.