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Association of Maternal Autoimmune Diseases and Autism Spectrum Disorders: A Nationwide Population Study in Taiwan

Huey-Ling Chiang, M.D., Ph.D., Yu-Wen Hu, M.D., Chiu-Mei Yeh, M.S., Tzeng-Ji Chen, M.D., Chun-Lin Chen, M.D., M.A.

Objective: Increased risk of autism spectrum disorder (ASD) has been observed in children with family history of autoimmune diseases, implying a common genetic background in these two conditions. In recent years, more evidence supports the hypothesis that maternal immune activation during pregnancy may also play a rôle in offspring during neural developmental process, leading to ASDassociated pathophysiology. We intended to study whether maternal autoimmune diseases are associated with ASD children. Method: We enrolled the patients with ASD from the Taiwan National Health Insurance (NHI) database in year 1997- 2011. We identifi ed 8,428 mother-child dyads in patients diagnosed with ASD retrieved from the Registry for Catastrophic Illness Patients database. The control group of individuals without ASD was selected from NHI database with the ratio of 1: 4. They were matched with each individual in the ASD group on the basis of age, gender, and time of enrollment. The autoimmune disorders in their mothers were also based on the certifi cate of catastrophic illness. The risks of mothers' autoimmune disorders were compared between the ASD group and the control group. Results: Autoimmune disorders were documented in 60 (0.71%) mothers with an ASD child. The percentage of overall and each autoimmune disorder did not show any signifi cant difference between those mothers with and without an ASD children. Conclusion: In this retrospective study, we did not demonstrate that maternal autoimmune disorders are signifi cantly associated with the risk of ASD in children.
Key Word autism spectrum disorder, autoimmune, maternal risk factor, Taiwan National Health Insurance Research Database
Editorial Committe, Taiwanese Journal of Psychiatry
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