Maternal preconception and prenatal stressful life events in association with child neurodevelopmental outcome in MARBLES: A high familial likelihood cohort

Prenatal stressful life events (SLEs) have been inconsistently associated with autism spectrum disorder (ASD). Mothers who are already raising a child with ASD could experience compounding effects of prenatal SLEs. This study prospectively examined prenatal SLEs in association with child neurodevelopmental outcomes in a high familial likelihood cohort. Participants were 317 mother-child pairs from the Markers of Autism Risk in Babies: Learning Early Signs (MARBLES) Study, where pregnant women have previously had at least one other child with ASD. Mothers were interviewed during and at the end of pregnancy about whether they had experienced any of 7 SLE categories relating to finance, marriage, death, and more. Child neurodevelopment at three years old was classified as typically developing (TD), Non-TD, or ASD using an algorithm applied to Autism Diagnostic Observation Schedule (ADOS) and the Mullen Scales of Early Learning (MSEL) scores. Relative risk ratios (RRR) with TD as the reference outcome were estimated using multinomial logistic regression. Experiencing legal problems was significantly associated with an increased relative risk of child Non-TD (RRR 3.75; 95% CI: 1.15, 12.22). However, this finding was based on a small sample size (n = 6) and should be interpreted with caution. All other associations with Non-TD and ASD were non-significant. Findings agree with previous literature suggesting prenatal SLEs might not increase likelihood for ASD and most were not associated with Non-TD. Future studies measuring perceived stress or stress biomarkers are warranted to further understand the true association of prenatal stress and likelihood of ASD.