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Maternal Anxiety and Depression Are Associated with Autism Spectrum Disorder Phenotypes in Preschol Children
Anxiety and depression are common among individuals with autism spectrum disorder (ASD), and a number of studies have found maternal anxiety and depression to be associated with the development of ASD in offspring. Several studies highlighted an association between maternal depression and specific ASD phenotypes characterized by higher adaptive and cognitive functioning and increased rates of problem behaviors in the child with ASD.
Objectives:
We explored whether a history of maternal anxiety and depression was associated with ASD phenotypes in the child. We hypothesized that maternal anxiety or depression would be associated with a profile in children with ASD characterized by increased rates of anxiety and depression, average learning abilities, and mild language and motor delays.
Methods:
The Study to Explore Early Development (SEED) is a multisite, community-based study of children 30-68 months of age. SEED was designed to describe ASD phenotypes and investigate how genetic and environmental factors are associated with ASD profiles. Participants were 672 children with ASD and their mothers. Children with ASD were classified after a comprehensive developmental evaluation with gold-standard diagnostic instruments. Child ASD phenotypes were derived from latent class analysis of extensive behavioral, developmental, and medical data. Four phenotypes best described children with ASD: (1) Mild Language Delay with Cognitive Rigidity, (2) Significant Developmental Delay with Repetitive Motor Behaviors, (3) General Developmental Delay, and (4) Mild Language and Motor Delay with Dysregulation (e.g., anxiety/depression) or “Dysregulated ASD.” Mothers completed a medical history questionnaire and reported whether a doctor diagnosed them with anxiety or depression before the birth of their child. To assess associations between maternal anxiety or depression and child phenotypic class, we conducted a multinomial logistic regression weighted for classification error and adjusted for confounding. Type 2 ASD (i.e., Significant Developmental Delay with Repetitive Motor Behaviors) was chosen as the reference category for regression analyses.
Results:
22.6% of mothers reported being diagnosed with anxiety or depression before the birth of their child. Type 4 or Dysregulated ASD was associated with a reported history of maternal anxiety or depression (Odds ratio 2.73, 95% confidence interval: 1.23, 5.46); and the association was stronger when both conditions were present (Odds ratio 4.73, (95% confidence interval: 1.35, 16.5). Maternal anxiety or depression was not associated with other ASD phenotypes.
Conclusions:
We conclude that maternal anxiety and depression are significantly associated with an ASD phenotype characterized by increased rates of anxiety and depression, typical learning abilities, and mild delays in language and motor skills in preschool children. Our findings highlight the potential for shared etiologic pathways between anxiety, depression, and Dysregulated ASD that can be explored in future research studies.