Is the association between mothers’ autistic traits and childhood autistic traits moderated by maternal pre-pregnancy body mass index?

Background: Previous studies showed that there is a positive association between mothers’ and children’s autistic traits. We also tested if this association is more pronounced in mothers with a higher pre-pregnancy body mass index (BMI). Method: The study was embedded in two cohorts with information available for 4,659 participants from the Generation R and for 179 participants from the Cambridge Ultrasound Siblings and Parents Project (CUSP) cohort. In both cohorts, maternal autistic traits were assessed using the short form of the Autism Spectrum Quotient, and information about maternal height and weight before pregnancy was obtained by questionnaire. Child autistic traits were assessed with the short form of Social Responsiveness Scale in Generation R (M = 13.5 years) and with the Quantitative Checklist for Autism in Toddlers (Q-CHAT) in the CUSP cohort (M = 1.6 years). Result: Higher maternal autistic traits were associated with higher autistic traits in toddlerhood (CUSP cohort; βadjusted = 0.20, p &lt; 0.01), in early childhood (Generation R; βadjusted = 0.19, p &lt; 0.01), and in early adolescence (Generation R; βadjusted = 0.16, p &lt; 0.01). Furthermore, a higher maternal pre-pregnancy BMI was associated with higher child autistic traits, but only in Generation R (βadjusted = 0.03, p &lt; 0.01). There was no significant moderating effect of maternal pre-pregnancy BMI on the association between autistic traits of mothers and children, neither in Generation R nor in CUSP. In addition, child autistic traits scores were significantly higher in mothers who were underweight and in mothers who were overweight compared to mothers with a healthy weight. Conclusion: We confirm the association between maternal and child autistic traits in toddlerhood, early childhood, and early adolescence. Potential interacting neurobiological processes remain to be confirmed.</p

Is the association between mothers’ autistic traits and childhood autistic traits moderated by maternal pre-pregnancy body mass index?

Background: Previous studies showed that there is a positive association between mothers’ and children’s autistic traits. We also tested if this association is more pronounced in mothers with a higher pre-pregnancy body mass index (BMI). Method: The study was embedded in two cohorts with information available for 4,659 participants from the Generation R and for 179 participants from the Cambridge Ultrasound Siblings and Parents Project (CUSP) cohort. In both cohorts, maternal autistic traits were assessed using the short form of the Autism Spectrum Quotient, and information about maternal height and weight before pregnancy was obtained by questionnaire. Child autistic traits were assessed with the short form of Social Responsiveness Scale in Generation R (M = 13.5 years) and with the Quantitative Checklist for Autism in Toddlers (Q-CHAT) in the CUSP cohort (M = 1.6 years). Result: Higher maternal autistic traits were associated with higher autistic traits in toddlerhood (CUSP cohort; βadjusted = 0.20, p &lt; 0.01), in early childhood (Generation R; βadjusted = 0.19, p &lt; 0.01), and in early adolescence (Generation R; βadjusted = 0.16, p &lt; 0.01). Furthermore, a higher maternal pre-pregnancy BMI was associated with higher child autistic traits, but only in Generation R (βadjusted = 0.03, p &lt; 0.01). There was no significant moderating effect of maternal pre-pregnancy BMI on the association between autistic traits of mothers and children, neither in Generation R nor in CUSP. In addition, child autistic traits scores were significantly higher in mothers who were underweight and in mothers who were overweight compared to mothers with a healthy weight. Conclusion: We confirm the association between maternal and child autistic traits in toddlerhood, early childhood, and early adolescence. Potential interacting neurobiological processes remain to be confirmed.</p

Fetal brain growth and infant autistic traits

Background: Structural differences exist in the brains of autistic individuals. To date only a few studies have explored the relationship between fetal brain growth and later infant autistic traits, and some have used fetal head circumference (HC) as a proxy for brain development. These findings have been inconsistent. Here we investigate whether fetal subregional brain measurements correlate with autistic traits in toddlers. Methods: A total of 219 singleton pregnancies (104 males and 115 females) were recruited at the Rosie Hospital, Cambridge, UK. 2D ultrasound was performed at 12-, 20- and between 26 and 30 weeks of pregnancy, measuring head circumference (HC), ventricular atrium (VA) and transcerebellar diameter (TCD). A total of 179 infants were followed up at 18–20 months of age and completed the quantitative checklist for autism in toddlers (Q-CHAT) to measure autistic traits. Results: Q-CHAT scores at 18–20 months of age were positively associated with TCD size at 20 weeks and with HC at 28 weeks, in univariate analyses, and in multiple regression models which controlled for sex, maternal age and birth weight. Limitations: Due to the nature and location of the study, ascertainment bias could also have contributed to the recruitment of volunteer mothers with a higher than typical range of autistic traits and/or with a significant interest in the neurodevelopment of their children. Conclusion: Prenatal brain growth is associated with toddler autistic traits and this can be ascertained via ultrasound starting at 20 weeks gestation

An ode to fetal, infant, and toddler neuroimaging: chronicling early clinical to research applications with MRI, and an introduction to an academic society connecting the field

Fetal, infant, and toddler neuroimaging is commonly thought of as a development of modern times (last two decades). Yet, this field mobilized shortly after the discovery and implementation of MRI technology. Here, we provide a review of the parallel advancements in the fields of fetal, infant, and toddler neuroimaging, noting the shifts from clinical to research use, and the ongoing challenges in this fast-growing field. We chronicle the pioneering science of fetal, infant, and toddler neuroimaging, highlighting the early studies that set the stage for modern advances in imaging during this developmental period, and the large-scale multi-site efforts which ultimately led to the explosion of interest in the field today. Lastly, we consider the growing pains of the community and the need for an academic society that bridges expertise in developmental neuroscience, clinical science, as well as computational and biomedical engineering, to ensure special consideration of the vulnerable mother-offspring dyad (especially during pregnancy), data quality, and image processing tools that are created, rather than adapted, for the young brain.UL1 TR001863 - NCATS NIH HHS; R01 MH117983 - NIMH NIH HHS; K24 MH127381 - NIMH NIH HHS; UL1 TR001873 - NCATS NIH HHS; TL1 TR001875 - NCATS NIH HHS; T32 MH018268 - NIMH NIH HHS; ZIA MH002782 - Intramural NIH HHS; UL1 TR003015 - NCATS NIH HHS; KL2 TR003016 - NCATS NIH HHS; R01 HD065762 - NICHD NIH HHS; R03 EB022754 - NIBIB NIH HHS; R21 HD095338 - NICHD NIH HHS; R01 HD093578 - NICHD NIH HHS; R01 HD099846 - NICHD NIH HHS; R01 HD100560 - NICHD NIH HHSPublished versio

COVID-19 in the Context of Pregnancy, Infancy &amp; Parenting

Our first 1000 days (from conception to two years of age) are a critical window of vulnerability from exposure to stress, socio-economic and health challenges. While the national lockdown saved lives, secondary consequences may impart an acute and potentially enduring influence - on the economic and psychological adjustment of parents, early parent-child interactions and physical growth and cognitive development of infants – well beyond the current crisis. Through a national online web-based questionnaire, we will further our understanding of how (i) access and attitudes towards social, medical and financial support during the COVID-19 pandemic associate with parental stress, anxiety and depression; (ii) COVID-19 related restrictions impact on the depth and breadth of social interactions that young infants experience in the first six months of life and (iii) parental mental health and social interaction experiences mediate physical, social and cognitive development in infants. The purpose of this study is to measure the impact of COVID-19 on expectant and new parents and their infants across the UK so that we can 1) develop an evidence base for future policy to support the adjustment of families in this current crisis and in future public health emergencies, 2) identify those most vulnerable in ‘generation COVID’ who may benefit from early intervention and 3) increase participation, and insight into the experience, of underrepresented regional/socio-economic and ethnic groups across the UK

Fetal Biometry and Early Behavioural Development

The overall aim of this thesis is to explore the use of standardised fetal biometric measurements and their relationship, if any, with later infant outcomes. In addition, the possible influence of fetal sex and several maternal conditions (polycystic ovary syndrome (PCOS), hirsutism and autism) on fetal growth measurements, are explored. The biometrics include anogenital distance (AGD), several brain measurements (transcerebellar diameter (TCD), ventricular atrium (VA)) and head circumference (HC). AGD was included as a proxy for prenatal sex steroid hormones, given the importance of the latter as an influence of brain development and for a number of autistic traits postnatally. The fetuses were assessed using ultrasound at 12-, 20- and between 26-30 weeks gestation and followed up at 18-20 months’ of age to see if these fetal biometric measurements are associated with later language and sensory development, as well as early autistic traits. Chapter 1 gives an overview of current research on fetal development, as well as the different methodologies used. This includes an introduction to the maternal conditions considered in this thesis and the fetal biometrics (HC, VA, TCD and AGD) that are measured. Chapter 2 explores potential sex differences and the influence that maternal conditions (PCOS, hirsutism and autism) may have on developing fetal brain structure. Results indicate no significant sex differences between fetal brain measurements, or growth velocity. In addition, there was no relationship between maternal conditions and the fetal growth measurements. Chapter 3 explores the feasibility of measuring AGD in utero (as a proxy for prenatal sex steroid hormones). Further, it examines the influence of maternal conditions such as PCOS (which is associated with increased testosterone) on AGD in utero. Significant sex differences in AGD were demonstrated, supporting previous findings. Results showed no relationship between fetal AGD and maternal testosterone related conditions (autism, PCOS and hirsutism). Chapter 4 examines population based differences in fetal biometry and the applicability of findings from Chapter 3 to an Israeli population. Results indicated that there were significant differences in AGD between Israeli and UK populations, potentially attributed to ethnicity. This supports the need for population-based or customisable growth charts if this measure is to be used clinically. Chapter 5 explores the relationship between fetal brain measures and early behavioural development at 18-20 months. The outcome measures include the Quantitative Checklist for Autism in Toddlers (Q-CHAT), the MacArthur-Bates Communicative Development Inventory (MB-CDI) short form and the Infant/Toddler Sensory Profile (ITSP). Results indicated a significant positive relationship between TCD and VA size at 20 weeks and Q-CHAT scores at 18-20 months’ of age, which remained significant for females only when examining sex differences. There were no significant associations between the other fetal brain measurements and the MB-CDI short form, Q-CHAT or the ITSP. Chapter 6 explores the relationship between fetal AGD and early behavioural development at 18-20 months. No significant relationships were found between fetal AGD length and infant development. The results from the thesis are summarised in Chapter 7 where broader theoretical and clinical implications of the findings are discussed. From the results presented in this thesis, it is apparent that one biometric measure (AGD) displays sex-based differences and will require sex-specific growth charts if it is to be used clinically. However further research is warranted to assess the clinical usefulness of AGD as a measurement. Additionally, for the first time a relationship between gross fetal brain structures (TCD and VA) and early autistic traits was measured. In conclusion, this thesis discussed the possible use of novel biometrics (AGD) for research and clinical use. Additionally, the potential for using fetal biometrics to help assess later infant outcomes, in particular autistic traits is presented

Systematic review and meta-analysis of associations between digit ratio (2D:4D) and congenital adrenal hyperplasia

Meta-analysis of the association between 2d:4d measured pre-natal androgen exposure and congenital adrenal hyperplasi

Autistic mothers' perinatal well-being and parenting styles.

Peer reviewed: TrueFunder: Autistica; FundRef: https://doi.org/10.13039/501100008161Funder: Pinsent Darwin FundFunder: NIHR Cambridge Biomedical Research Centre; FundRef: https://doi.org/10.13039/501100018956Funder: Sackler Trust; FundRef: https://doi.org/10.13039/100015656Funder: Autism Research TrustFunder: National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care East of England at Cambridgeshire and Peterborough NHS Foundation TrustFunder: Medical Research Council; FundRef: https://doi.org/10.13039/501100000265Autistic people can have difficulties during pregnancy and after giving birth, such as difficulty getting health care that meets their needs. Autistic people may therefore have lower well-being than non-autistic people during this time. We asked autistic and non-autistic people to fill in questionnaires measuring stress, depression, anxiety and satisfaction with life. They were asked to do this once during pregnancy, once 2 to 3 months after giving birth and once 6 months after giving birth. At 6 months after giving birth, they also filled in questionnaires about parenting. The autistic parents had higher stress, depression and anxiety scores than the non-autistic parents. For both groups, scores for anxiety went down over time. There were no differences between the groups on satisfaction with their life or how confident they were as a parent. There were no differences between the groups on most areas of parenting style, although autistic parents scored lower on parenting discipline. This study suggests that autistic people may be more stressed, depressed and anxious than non-autistic people during pregnancy and after giving birth. Autistic people therefore need good quality support during this time. This study also suggests that autistic and non-autistic parents may be just as likely to parent in positive ways such as being sensitive to their baby's needs

Generation COVID-19 - Should the foetus be worried?

AIM: The aim of this narrative review was to evaluate the risks, both direct and indirect, to the foetus from the COVID-19 pandemic. METHODS: Direct and indirect risks were defined as (a) vertical infection (congenital or intrapartum), (b) maternal infection and its sequelae, and (c) sources of maternal stress during lockdown, including social isolation and altered healthcare provision. RESULTS: Early studies suggest that vertical viral transmission is low; however, there may be an important effect of maternal infection on foetal growth and development. The impact of various degrees of lockdown on prospective mothers' health, habits and healthcare provision is of concern. In particular, increased maternal stress has been shown to have a significant effect on foetal brain development increasing the risk of mental health, and cognitive and behavioural disorders in later life. CONCLUSION: From the evidence available to date, direct risks to the foetus from the SARS-CoV-2 virus are low. Indirect effects of the pandemic, particularly resulting from the effect of maternal stress on the developing brain, can have lifelong detrimental impacts for this generation of children