Evidence map›Paper›PMID 41849261›Full record

ArticlePloS one2026

Perinatal and maternal factors associated with Autism Spectrum Disorder.

Susanna Edlund, Nils Haglund, Carl-Gustaf Bornehag, Chris Gennings, Hannu Kiviranta, Alexander Kolevzon, Christian Lindh, Panu Rantakokko, Abraham Reichenberg, Shanna Swan and 1 more

Abstract read
In one paragraph

Article in PloS one, 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

11 authors.

Susanna EdlundInstitution of Clinical Sciences, Lund, Department of Obstetrics and Gynecology, unit of reproduction epidemiology, Tornblad Institute, Lund University, Lund, Sweden.ORCID https://orcid.org/0000-0002-0798-0350
Nils HaglundInstitution of Clinical Sciences, Lund, Department of Obstetrics and Gynecology, unit of reproduction epidemiology, Tornblad Institute, Lund University, Lund, Sweden.
Carl-Gustaf BornehagDepartment of Health, Karlstad University, Karlstad, Sweden.
Chris GenningsDepartment of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America.
Hannu KivirantaDepartment of Health Security, Finnish Institute for Health and Welfare (THL), Kuopio, Finland.
Alexander KolevzonDepartment of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America.
Christian LindhDivision of Occupational and Environmental Medicine, Lund University, Lund, Sweden.
Panu RantakokkoDepartment of Health Security, Finnish Institute for Health and Welfare (THL), Kuopio, Finland.
Abraham ReichenbergDepartment of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America.
Shanna SwanDepartment of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America.
Karin KällénInstitution of Clinical Sciences, Lund, Department of Obstetrics and Gynecology, unit of reproduction epidemiology, Tornblad Institute, Lund University, Lund, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAutism spectrum disorder (ASD) is a heterogeneous neurodevelopmental condition influenced by both genetic and environmental factors. Prenatal and perinatal exposures have been implicated in ASD etiology, but their influence may vary across clinical subgroups, including subgroups defined by co-occurring intellectual disability (ID).

methodsWe conducted a population-based case-control study in southern Sweden including all children diagnosed with ASD before the age of 9, and whose mothers were born in Sweden. Diagnoses were confirmed through detailed medical record review, and information on ASD severity, ID status, and familial ASD were collected for subgroup analyses. A total of 996 ASD cases and 9,960 age- and sex-matched controls were identified from a regional perinatal database. Multivariable logistic regression estimated adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for maternal, obstetric, and neonatal factors.

resultsHigher maternal body mass index (BMI) in early pregnancy was associated with increased likelihood of ASD (adjusted odds ratio [aOR] 1.41-1.76 for overweight and obesity compared with normal weight), with broadly similar associations observed across ASD subgroups defined by severity, intellectual disability, and familial ASD. Maternal smoking in early pregnancy (aOR 1.49, 95% CI 1.22-1.82) and both elective (aOR 1.22, 95% CI 1.01-1.48) and emergency cesarean delivery (aOR 1.40, 95% CI 1.15-1.81) were also associated with higher odds of ASD, with generally stronger associations in children without intellectual disability and in those with less severe ASD. Subgroup-specific associations were observed for maternal epilepsy and gestational diabetes, while prematurity showed weaker associations than anticipated and was mainly observed in severe ASD and non-familial cases. Low Apgar scores at 5 minutes showed no consistent association with ASD.

conclusionsMultiple maternal and perinatal factors were associated with ASD in this large Swedish cohort. Stratified analyses by ASD severity, ID status, and familial ASD revealed both shared and subgroup-specific association patterns, underscoring the value of considering ASD heterogeneity in studies of neurodevelopmental variation.

Indexed as

Autism Spectrum DisorderPrenatal Exposure Delayed EffectsAdultBody Mass IndexCase-Control StudiesChildChild, PreschoolFemaleHumansInfant, NewbornIntellectual DisabilityMaleOdds RatioPregnancyRisk FactorsSweden

Identifiers

PMID41849261
PMCPMC12998875

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.