#Grand Rounds

Do Maternal Multivitamin Supplements Decrease Risk for Autism in Offspring?

BACKGROUND AND PURPOSE:

Research suggests autism spectrum disorder (ASD) may develop prenatally
Previous studies are conflicting regarding whether maternal nutrition may impact ASD
Confounding factors such as socioeconomic factors, general disease and pregnancy characteristics can impact results
Using multiple strategies to account for confounders, DeVilbiss et al. (BMJ, 2017) assessed whether nutritional supplementation during pregnancy is associated with reduce risk of ASD with and without intellectual disability in offspring

Observational prospective cohort study (2001 – 2011)
Multivariable logistic regression, sibling controls, and propensity score matching strategies were used to address confounders
Mother-child pairs were assessed for their exposure to multivitamin, iron, and folic acid supplement
Main outcomes were diagnosis of ASD with and without intellectual disability in children

Study sample was 237,107 mother-child pairs
Follow up was 4 to 15 years
Lower likelihood of ASD with intellectual disability compared with non-use of multivitamins, iron, and folic acid in all analyses (odds ratio 0.69, 95% confidence interval 0.57 to 0.84) but statistical significance in logistic regression vs trending in other approaches
- Multivitamin use was not associated with ASD without intellectual disability
There was no consistent evidence that either iron or folic acid use were inversely associated with ASD prevalence

Maternal multivitamin supplementation during pregnancy may be associated with reduced risk for ASD with intellectual disability in offspring
Further studies are needed to assess the relationship between maternal nutrition and autism and if there is a critical time regarding exposure
Authors note that supplementation varies between countries and could explain inconsistent results in the literature

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