Evidence map›Paper›PMID 41806249›Full record

ArticleJournal of autism and developmental disorders2026

Individual and Combined Associations of Maternal Fever, Placental Inflammation, and Prematurity With Autism and ADHD.

Alexandra Starr, Xueqi Qu, Xiumei Hong, Sally Safi, Xiaobin Wang

Abstract read
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In one paragraph

Article in Journal of autism and developmental disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Alexandra StarrDepartment of Population, Family and Reproductive HealthCenter on Early Life Origins of Disease, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, E4132, Baltimore, MD, 21205-2179, USA.
Xueqi QuDepartment of Population, Family and Reproductive HealthCenter on Early Life Origins of Disease, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, E4132, Baltimore, MD, 21205-2179, USA.
Xiumei HongDepartment of Population, Family and Reproductive HealthCenter on Early Life Origins of Disease, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, E4132, Baltimore, MD, 21205-2179, USA.
Sally SafiDepartment of Population, Family and Reproductive HealthCenter on Early Life Origins of Disease, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, E4132, Baltimore, MD, 21205-2179, USA.
Xiaobin WangDepartment of Population, Family and Reproductive HealthCenter on Early Life Origins of Disease, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, E4132, Baltimore, MD, 21205-2179, USA. xwang82@jhu.edu.ORCID http://orcid.org/0000-0003-4451-302X

Funding

Maternal and Child Health Bureau UT7MC45949
6 · The paper itself

Abstract

purposePrenatal maternal immune activation (MIA) and preterm birth (PTB) have each been linked to increased risk for neurodevelopmental disorders (NDDs), including autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). However, MIA definitions varied across studies and few investigations have examined their combined effects. This study assessed the relationship between MIA and NDDs using two MIA definitions: binary (fever and/or placental inflammation) and a four-level subtype (fever only, inflammation only, both, or neither); and examined the joint associations of MIA and PTB with NDDs.

methodsThis report includes 2,975 mother-child dyads. Adjusted logistic regressions estimated associations between MIA and NDDs. Additive interactions between MIA and PTB were assessed using the Relative Excess Risk due to Interaction (RERI). Mediation-moderation analyses examined the extent to which the association between MIA and ADHD was statistically explained by PTB.

resultsBinary MIA was associated with elevated odds of NDD (adjusted odds ratio [aOR] = 1.33, 1.08-1.64) and ADHD (aOR = 1.71, 1.30-2.25). Using the four-level definition, the highest risk was among children exposed to both maternal fever and placental inflammation (NDD: aOR = 3.25, 1.87-5.66; ADHD: aOR = 3.16, 1.50-6.65). Co-occurrence of binary MIA and PTB yielded a RERI of 0.88 (0.28-1.48) for ADHD, while both (Fever + IUI) MIA subtype and PTB yielded RERI of 2.14 (0.66-3.62), indicating greater-than-additive joint associations. In mediation analyses, we found that the positive associations of MIA with NDD and ADHD were partly explained by PTB.

conclusionPlacental inflammation, more so than fever, is associated with NDDs and ADHD risk, supporting the value of MIA subtype measure. MIA and PTB are jointly associated with increased ADHD risk beyond additivity, and PTB partially mediated the association between MIA and ADHD.

Indexed as

Attention-deficit/hyperactivity disorder (ADHD)Autism spectrum disorder (ASD)Boston birth cohort (BBC)Maternal immune activation (MIA)Neurodevelopmental disorders (NDDs)Placental inflammationPreterm birth (PTB)

Identifiers

PMID41806249

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.