The Association Between Prenatal Anxiety and Depression and Autism Spectrum Disorder With Gastrointestinal Symptoms in Children: Case-Control Study

Background Studies have indicated that maternal anxiety and depression during pregnancy can contribute to neurodevelopmental disorders and gut flora dysbiosis in children. However, it is unclear whether these factors increase the risk of autism spectrum disorder (ASD) with gastrointestinal (GI) symptoms in children. Objective This study aimed to analyze the relationship between maternal anxiety and depression during pregnancy and ASD with GI symptoms. Methods A total of 470 children with ASD and 486 children with typical development were enrolled in the study. The caregivers of all enrolled children completed questionnaires, including information on maternal mental health and GI symptoms. Results The percentage of maternal prenatal anxiety or depression was significantly higher in the ASD group than in the typical development group ( P <.001). Children whose mothers experienced anxiety or depression during pregnancy had substantially higher risk of developing ASD than those whose mothers did not experience these conditions (unadjusted odds ratio [OR] 4.274, 95% CI 2.799-6.526; adjusted OR 3.897, 95% CI 2.481-6.119). For children with ASD, those whose mothers had prenatal anxiety or depression had a significantly higher risk of GI symptoms than those whose mothers did not have these conditions (unadjusted OR 1.883, 95% CI 1.209-2.934; adjusted OR 1.943, 95% CI 1.236-3.054). Conclusions Mothers who experience anxiety or depression during pregnancy may have a higher likelihood of their children developing ASD with GI symptoms.