Aug 2026· Child Psychiatry and Human Development· 0 citations· 42 references
Medicine
TL;DR
Findings support low birth weight as an early marker of neurodevelopmental vulnerability across NDD outcomes.
Abstract
Increasing prevalence of neurodevelopmental disorders (NDDs) is a growing public health concern. Identifying early risk markers may facilitate earlier intervention and reduce long-term burden. Although birth weight has been widely studied in relation to NDDs, evidence from clinically ascertained samples with single and overlapping diagnoses remains limited. In this case-control study, we compared birth weight between clinically referred individuals with intellectual disability (ID), autism spectrum disorder (ASD), and attention-deficit/hyperactivity disorder (ADHD) from the Norwegian BUPgen registry (n = 720) and a population-based sample from the Norwegian Mother, Father and Child Cohort Study (MoBa) (n = 98,716). Perinatal data were obtained through linkage to the Medical Birth Registry of Norway. Associations were examined using logistic regression adjusted for gestational age, sex, and parental age. Additional analyses assessed interactions by sex and parental age, and birth weight categories. For each 100 g decrease in birth weight, odds significantly increased for the groups any NDD (one or more NDD diagnoses; OR = 1.04) and multiple diagnoses (two or more co-occurring NDDs; OR = 1.07). In diagnosis specific analyses, odds significantly increased for ID (OR = 1.15) and ASD (OR = 1.03). No interactions were observed. In categorical analyses, low birth weight was associated with higher odds of ID (OR = 8.27, p < 0.001), multiple diagnoses (OR = 4.96, p < 0.001), and any NDD (OR = 2.11, p = 0.002). No associations were observed for high birth weight. These findings support low birth weight as an early marker of neurodevelopmental vulnerability across NDD outcomes.
It is suggested that family structure may represent an important early-life context for neurodevelopment and may help inform developmental surveillance in societies experiencing declining fertility rates and delayed childbearing.
Yi-Yu Su, Chi-Jen Chen, Mei-Huei Chen et al.· Early Human Development· 0 citations
Importance
Diagnoses of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) have increased substantially in recent decades, but it is unclear whether associations of prediagnostic characteristics with these diagnoses have changed over time.
Objective
To examine temporal trends in associations between well-defined risk factors and subsequent diagnoses of ADHD and ASD.
Design, Setting, and Participants
This population-based matched case-control study was conducted using nationwide Danish registry data for individuals born between January 1, 1994, and December 31, 2022, followed up to age 18 years. Individuals diagnosed with ADHD or ASD before age 18 years between 2012 and 2022 were included as cases. Each case was matched to 10 controls without these diagnoses by sex, birth year, municipality of residence, and country of birth. Data were analyzed from April 2025 through June 2026.
Exposure
A list of 19 prediagnostic characteristics, including parental and family factors, birth and perinatal factors, and health care use.
Main Outcomes and Measures
Associations between prediagnostic characteristics and ADHD or ASD diagnoses by year of diagnosis, estimated as odds ratios (ORs) with 95% CIs using conditional logistic regression.
Results
Of 2 194 951 children and adolescents in the registry, 100 323 individuals (4.6%) were diagnosed with ADHD or ASD before age 18 years, among whom 71 317 children and adolescents were diagnosed between 2012 and 2022 and included as cases (26 452 female [37.1%]; median [IQR] age at diagnosis, 11.4 [8.1 to 14.9] years), matched with 713 170 controls. Individuals diagnosed with ADHD or ASD differed from controls across all characteristics, but differences diminished over time, with ORs attenuating toward the null, particularly for socioeconomic and perinatal factors. For example, the OR for low birth weight decreased from 1.54 (95% CI, 1.41 to 1.68) in 2012 to 2013 to 1.17 (95% CI, 1.10 to 1.24) in 2020 to 2022. Attenuation was greater for ADHD than ASD (eg, household income: mean yearly change in OR, 6.5% [95% CI, 5.7% to 7.3%] for ADHD; mean yearly change in OR, 0.7% [95% C, -0.1% to 1.5%] for ASD) and more pronounced among individuals diagnosed at ages 10 to 17 years than at younger ages. Patterns were similar across sexes and in analyses restricted to cases with higher diagnostic certainty.
Conclusions and relevance
This study found that from 2012 to 2022, children and adolescents diagnosed with ADHD or ASD became increasingly similar to peers without these diagnoses. These findings suggest that increasing diagnostic rates may reflect changes in diagnostic practices or health care capacity rather than changes in underlying risk alone and should not be interpreted as evidence that ADHD or ASD have become less impairing at the individual level.
Magnus Elias Tarp, M. L. Lousdal, C. U. Rask et al.· JAMA psychiatry· 1 citation
Background/Objectives: Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) substantially affect quality of life. Previous studies have not evaluated whether the associations between early-life antibiotic exposure and the risks of ASD and ADHD differ according to the antibiotic agents administered during infancy. Methods: This nationwide case–control study used Taiwan’s National Health Insurance Research Database, Birth Reporting Database, and Maternal and Child Health Database. The cohort included 1,693,718 term neonates born between 2004 and 2015 and followed through to 2022. For ASD (n = 7265) and ADHD (n = 39,056) cases, antibiotic-exposed children were matched 1:1 with unexposed children based on sex, gestational age, birth weight, and birth year. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox proportional hazards models. Results: Oral antibiotic exposure was associated with lower ASD but higher ADHD risk, while parenteral exposure was associated with increased risks of both outcomes. Amoxicillin and erythromycin exposure during the first year of life were associated with lower ASD risk, whereas ampicillin exposure at 4–12 months was associated with higher ASD risk (all p £ 0.033). For ADHD, exposure to amoxicillin/clavulanic acid, cefixime, ampicillin, and ampicillin/sulbactam was associated with increased risk, whereas erythromycin, cephalexin, and sulfamethoxazole-trimethoprim were associated with reduced risk (all p < 0.047). Conclusions: Associations between early-life antibiotic exposure and the risks of ASD and ADHD varied according to antibiotic agents, route of administration, and timing of exposure. These findings may help explain inconsistencies among previous studies and inform antibiotic prescribing during infancy.
A familial background of autism, male gender, premature birth, and admission to a neonatal intensive care unit were notably more prevalent in children with autism, underscoring populations who may require enhanced developmental monitoring.
M. Bashtawi, Ayah A. Al-zgool, Dima A. Al Sharman et al.· Maternal and Child Health Jo...· 0 citations
ACEs were associated with adult ASD and ADHD traits and related symptom subdomains in adulthood and linked to specific ASD symptoms and ADHD symptoms in adulthood.
Hiroki Yamada, Toshinori Nakamura, Tomonari Yoshizawa et al.· Psychiatry and Clinical Neur...· 0 citations
To investigate the long-term risk of rheumatoid arthritis (RA) among individuals with autism spectrum disorder (ASD), addressing potential immune comorbidity in ASD populations. A population-based matched cohort was assembled using Swedish registers, including 46,164 individuals diagnosed with ASD between 1987 and 2017, matched to 4,634,895 controls by sex and birth year. Cohort members were followed from age 18 until RA diagnosis, death, emigration, or end of follow-up, providing up to 30 years of observation into adulthood. Cox proportional hazards models estimated hazard ratios (HR) for RA, with sensitivity analyses adjusting for parental autoimmune, psychiatric history, and socioeconomic status. RA diagnosis rates were similar between individuals with ASD (n = 58, 0.13%) and controls (n = 5484, 0.12%), with no increased risk: overall HR = 1.06 (95% CI 0.82-1.37), seropositive HR = 1.00 (0.67-1.48), and seronegative HR = 1.12 (0.79-1.57). Complementary analyses adjusting for parental psychiatric history, autoimmune conditions, and socioeconomic factors yielded consistent null findings (HR = 1.34, 95% CI 0.97-1.84). Sensitivity analyses, including accelerated failure time models and alternative RA subtype definitions, confirmed these results. This large-scale population study does not suggest an increased RA risk in individuals with ASD. Despite suggested immune dysfunction in ASD and shared genetic pathways with autoimmune conditions, we did not observe evidence that ASD is associated with elevated RA risk during adulthood; In conclusion, these findings inform understanding of autoimmune comorbidity patterns in autism and may guide evidence-based clinical monitoring for autistic adults.
Evora Hailin Zhu, Stephen Z. Levine, M. Morin et al.· Autism Research· 0 citations
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