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Maternal Prenatal Vitamin Use and Risk for Autism Spectrum Disorder in the Marbles Prospective Study of Enriched-Risk Siblings
In population-based studies, maternal periconceptional folic acid intake has been inconsistently associated with reduced risk for autism spectrum disorder (ASD) in the child. No study to date has examined the association with recurrence risk in a prospective study of enriched-risk families having children with ASD.
Objectives:
To examine whether maternal prenatal vitamin supplementation was associated with decreased ASD risk in subsequent siblings of children with ASD.
Methods:
Design: MARBLES (Markers of Autism Risk in Babies: Learning Early Signs) prospective pregnancy cohort study of younger siblings of children with ASD who were born from 2006-2013 and followed up to 3 years of age.
Setting: Participants within driving distance to the University of California Davis MIND Institute in Sacramento, California recruited primarily from the families receiving services for children with ASD in the Department of Developmental Services.
Participants: 205 younger siblings at high risk for ASD born to 189 mothers in the MARBLES cohort study by December 31, 2013 and received algorithmic clinical diagnoses at 3-years.
Exposure: Prenatal vitamin use prospectively collected through maternal interviews, including information which months they were taken from 6 months before pregnancy, throughout pregnancy, and while breastfeeding, how often they were taken, and at what dose.
Primary Outcome: Algorithmic diagnosis of ASD, other non-typical development (Non-TD), or typical development was determined based on scores on the Autism Diagnostic Observation Schedule and the Mullen Scales of Early Learning.
Results:
Children whose mothers reported taking a prenatal vitamin during the first month of pregnancy were less likely to be diagnosed with ASD than children whose mothers did not report taking a prenatal vitamin in pregnancy month one (RRadjusted = 0.47 [95% CI, 0.25 to 0.78]).
Conclusions:
Taking prenatal vitamin supplements daily during the first month of pregnancy could reduce ASD in subsequent high-risk children. Additional research is needed to confirm these results and investigate mechanisms to inform public health recommendations for ASD prevention in affected families.