Prenatal maternal autoimmune disorders and the risk of developmental disorders

Mothers with certain autoimmune disorders give birth to children who develop autism at over twice the rate as mothers without these disorders. While many maternal autoimmune disorders increase the risk of several types of mental disorders in offspring, lupus and Hashimoto’s disease are most pronounced, doubling the risk of autism. Thus, these two conditions may place a significant immune load on the developing fetus, presumably coinciding with critical periods in fetal nervous system development. This maternal immune activation may be further impacted by environmental stressors that, along with genetic mechanisms, further compromise fetal development. It is thus critically important for prenatal care to be multidisciplinary, particularly for women with autoimmune disorders. Managing the environmental oxidative stressors may help mitigate the increased risk due to autoimmune disorders and allow fetal development to proceed on schedule. Given that the environmental stressors such as malnutrition, infection, and pollution can adversely affect fetal development, implementing proactive strategies to address these factors during pregnancy, combined with improved early screening of children, would offer significant societal benefits. This review examines evidence for a link between maternal autoimmunity and considers mechanisms that may be in play to increase the propensity of autism development.