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Lower birth weight indicates higher risk of autistic traits in discordant twin pairs

Published online by Cambridge University Press:  02 December 2011

M. Losh ,
D. Esserman ,
H. Anckarsäter ,
P. F. Sullivan  and
P. Lichtenstein
M. Losh*
Affiliation:
Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, USA
D. Esserman
Affiliation:
Department of Medicine, Division of General Medicine and Clinical Epidemiology, UNC Chapel Hill, NC, USA Department of Biostatistics, Gillings School of Global Public Health, UNC Chapel Hill, NC, USA
H. Anckarsäter
Affiliation:
Department of Clinical Sciences, Lund University, Sweden Institute of Neuroscience and Physiology, University of Gothenburg, Sweden
P. F. Sullivan
Affiliation:
Department of Genetics, UNC Chapel Hill, NC, USA
P. Lichtenstein
Affiliation:
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden
*
*Address for correspondence: M. Losh, Ph.D., Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, 2240 Campus Drive, 2-340 Frances Searle, Northwestern University, Evanston, IL 60208, USA. (Email: [email protected])
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Abstract

Background

Autism spectrum disorder (ASD) is a neurodevelopmental disorder of complex etiology. Although strong evidence supports the causal role of genetic factors, environmental risk factors have also been implicated. This study used a co-twin–control design to investigate low birth weight as a risk factor for ASD.

Method

We studied a population-based sample of 3715 same-sex twin pairs participating in the Child and Adolescent Twin Study of Sweden (CATSS). ASD was assessed using a structured parent interview for screening of ASD and related developmental disorders, based on DSM-IV criteria. Birth weight was obtained from medical birth records maintained by the Swedish Medical Birth Registry.

Results

Twins lower in birth weight in ASD-discordant twin pairs (n=34) were more than three times more likely to meet criteria for ASD than heavier twins [odds ratio (OR) 3.25]. Analyses of birth weight as a continuous risk factor showed a 13% reduction in risk of ASD for every 100 g increase in birth weight (n=78). Analysis of the effect of birth weight on ASD symptoms in the entire population (most of whom did not have ASD) showed a modest association. That is, for every 100 g increase in birth weight, a 2% decrease in severity of ASD indexed by scores on the Autism – Tics, attention-deficit hyperactivity disorder (AD/HD), and other Comorbidities (A-TAC) inventory would be expected in the sample as a whole.

Conclusions

The data were consistent with the hypothesis that low birth weight confers risk to ASD. Thus, although genetic effects are of major importance, a non-genetic influence associated with birth weight may contribute to the development of ASD.

Keywords

Autismbirth weighttwin
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 5 , May 2012 , pp. 1091 - 1102
Copyright
Copyright © Cambridge University Press 2011

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References

Anckarsäter, H, Larson, T, Hansson, SL, Carlström, E, Ståhlberg, O, Gillberg, C, Råstam, R, Gillberg, C, Lichtenstein, P (2008). Child neurodevelopmental and behavioral problems are intercorrelated and dimensionally distributed in the general population. The Open Psychiatry Journal 2, 5–11.CrossRefGoogle Scholar
Anckarsäter, H, Lichtenstein, P, Carlstedt, E, Ståhlberg, O, Gillberg, C (2007). Psychometric development of The Autism – Tics, AD/HD and other Comorbidities (A-TAC) inventory. Full version with gate structure; based on clinic and general population data (www.childnps.se).Google Scholar
Bailey, A, Le Couteur, A, Gottesman, I, Bolton, P, Simonoff, E, Yuzda, E, Rutter, M (1995). Autism as a strongly genetic disorder: evidence from a British twin study. Psychological Medicine 25, 63–77.CrossRefGoogle ScholarPubMed
Ben Itzchak, E, Lahat, E, Zachor, DA (2011). Advanced parental ages and low birth weight in autism spectrum disorders – rates and effect on functioning. Research in Developmental Disabilities 32, 1776–1781.CrossRefGoogle ScholarPubMed
Beversdorf, DQ, Manning, SE, Hillier, A, Anderson, SL, Nordgren, RE, Walters, SE, Nagaraja, HN, Cooley, WC, Gaelic, SE, Bauman, ML (2005). Timing of prenatal stressors and autism. Journal of Autism and Developmental Disorders 35, 471–478.CrossRefGoogle ScholarPubMed
Blickstein, I (1991). The definition, diagnosis, and management of growth-discordant twins: an international census survey. Acta Geneticae Medicae et Gemellologiae 40, 345–351.CrossRefGoogle ScholarPubMed
Blickstein, I, Lancet, M (1988). The growth discordant twin. Obstetrical and Gynecological Survey 43, 509–515.CrossRefGoogle ScholarPubMed
Bolton, P, Macdonald, H, Pickles, A, Rios, P, Goode, S, Crowson, M, Bailey, A, Rutter, M (1994). A case-control family history study of autism. Journal of Child Psychology and Psychiatry 35, 877–900.CrossRefGoogle ScholarPubMed
Bolton, PF, Griffiths, PD (1997). Association of tuberous sclerosis of temporal lobes with autism and atypical autism. Lancet 349, 392–395.CrossRefGoogle ScholarPubMed
Bolton, PF, Murphy, M, Macdonald, H, Whitlock, B, Pickles, A, Rutter, M (1997). Obstetric complications in autism: consequences or causes of the condition? Journal of the American Academy of Child and Adolescent Psychiatry 36, 272–281.CrossRefGoogle ScholarPubMed
Branum, AM, Schoendorf, KC (2003). The effect of birth weight discordance on twin neonatal mortality. Obstetrics and Gynecology 101, 570–574.Google ScholarPubMed
Bryson, SE, Smith, IM, Eastwood, D (1988). Obstetrical suboptimality in autistic children. Journal of the American Academy of Child and Adolescent Psychiatry 27, 418–422.CrossRefGoogle ScholarPubMed
Burd, L, Severud, R, Kerbeshian, J, Klug, MG (1999). Prenatal and perinatal risk factors for autism. Journal of Perinatal Medicine 27, 441–450.Google ScholarPubMed
Burstyn, I, Sithole, F, Zwaigenbaum, L (2010). Autism spectrum disorders, maternal characteristics and obstetric complications among singletons born in Alberta, Canada. Chronic Diseases in Canada 30, 125–134.CrossRefGoogle ScholarPubMed
CDC (2009). Prevalence of autism spectrum disorders – Autism and Developmental Disabilities Monitoring Network, United States, 2006. MMWR CDC Surveillance Summaries 58, 1–20.Google Scholar
Chess, S (1971). Autism in children with congenital rubella. Journal of Autism and Childhood Schizophrenia 1, 33–47.CrossRefGoogle ScholarPubMed
Chess, S (1977). Follow-up report on autism in congenital rubella. Journal of Autism and Childhood Schizophrenia 7, 69–81.CrossRefGoogle ScholarPubMed
Clausson, B, Lichtenstein, P, Cnattingius, S (2000). Genetic influence on birthweight and gestational length determined by studies in offspring of twins. British Journal of Obstetrics and Gynaecology 107, 375–381.CrossRefGoogle ScholarPubMed
Constantino, JN, Todd, RD (2003). Autistic traits in the general population: a twin study. Archives of General Psychiatry 60, 524–530.CrossRefGoogle ScholarPubMed
Constantino, JN, Zhang, Y, Frazier, T, Abbacchi, AM, Law, P (2010). Sibling recurrence and the genetic epidemiology of autism. American Journal of Psychiatry 167, 1349–1356.CrossRefGoogle ScholarPubMed
Cryan, E, Byrne, M, O'Donovan, A, O'Callaghan, E (1996). A case-control study of obstetric complications and later autistic disorder. Journal of Autism and Developmental Disorders 26, 453–460.CrossRefGoogle ScholarPubMed
Deb, S, Prasad, KB, Seth, H, Eagles, JM (1997). A comparison of obstetric and neonatal complications between children with autistic disorder and their siblings. Journal of Intellectual Disability Research 41, 81–86.CrossRefGoogle ScholarPubMed
Falconer, DS (1981). Introduction to Quantitative Genetics, 2nd edn. Longman: London/New York.Google Scholar
Folstein, S, Rutter, M (1977). Infantile autism: a genetic study of 21 twin pairs. Journal of Child Psychology and Psychiatry 18, 297–321.CrossRefGoogle ScholarPubMed
Gielen, M, Lindsey, PJ, Derom, C, Loos, RJF, Souren, NY, Paulussen, ADC, Zeegers, MP, Derom, R, Vlietinck, R, Nijhuis, JG (2008). Twin-specific intrauterine ‘growth’ charts based on cross-sectional birthweight data. Twin Research and Human Genetics 11, 224–235.CrossRefGoogle ScholarPubMed
Hack, M, Taylor, HG, Schluchter, M, Andreias, L, Drotar, D, Klein, N (2009). Behavioral outcomes of extremely low birth weight children at age 8 years. Journal of Developmental and Behavioral Pediatrics 30, 112–130.CrossRefGoogle ScholarPubMed
Hallmayer, J, Cleveland, S, Torres, A, Phillips, J, Cohen, B, Torigoe, T, Miller, J, Fedele, A, Collins, J, Smith, K, Lotspeich, L, Croen, LA, Ozonoff, S, Lajonchere, C, Grether, JK, Risch, N (2011). Genetic heritability and shared environmental factors among twin pairs with autism. Archives of General Psychiatry. Published online: 4 July 2011. doi:10.1001/archgenpsychiatry.2011.76.CrossRefGoogle Scholar
Hansson, SL, Rojvall, AS, Rastam, M, Gillberg, C, Anckarsater, H (2005). Psychiatric telephone interview with parents for screening of childhood autism – tics, attention-deficit hyperactivity disorder and other comorbidities (A-TAC): preliminary reliability and validity. British Journal of Psychiatry 187, 262–267.CrossRefGoogle ScholarPubMed
Hoekstra, RA, Happe, F, Baron-Cohen, S, Ronald, A (2009). Association between extreme autistic traits and intellectual disability: insights from a general population twin study. British Journal of Psychiatry 195, 531–536.CrossRefGoogle ScholarPubMed
Hrubec, Z, Robinette, CD (1984). The study of human twins in medical research. New England Journal of Medicine 310, 435–441.CrossRefGoogle Scholar
Indredavik, MS, Vik, T, Heyerdahl, S, Kulseng, S, Fayers, P, Brubakk, AM (2004). Psychiatric symptoms and disorders in adolescents with low birth weight. Archives of Disease in Childhood. Fetal and Neonatal Edition 89, F445–F450.CrossRefGoogle ScholarPubMed
Juul-Dam, N, Townsend, J, Courchesne, E (2001). Prenatal, perinatal, and neonatal factors in autism, pervasive developmental disorder-not otherwise specified, and the general population. Pediatrics 107, E63.CrossRefGoogle ScholarPubMed
Kolevzon, A, Gross, R, Reichenberg, A (2007). Prenatal and perinatal risk factors for autism. Archives of Pediatrics and Adolescent Medicine 161, 326–333.CrossRefGoogle ScholarPubMed
Kuban, KC, O'Shea, TM, Allred, EN, Tager-Flusberg, H, Goldstein, DJ, Leviton, A (2009). Positive screening on the Modified Checklist for Autism in Toddlers (M-CHAT) in extremely low gestational age newborns. Journal of Pediatrics 154, 535–540.CrossRefGoogle ScholarPubMed
Larson, T, Anckarsater, H, Gillberg, C, Stahlberg, O, Carlstrom, E, Kadesjo, B, Rastam, M, Lichtenstein, P (2010). The autism – tics, AD/HD and other comorbidities inventory (A-TAC): further validation of a telephone interview for epidemiological research. BMC Psychiatry 10, 1.CrossRefGoogle ScholarPubMed
Larsson, HJ, Eaton, WW, Madsen, KM, Vestergaard, M, Olesen, AV, Agerbo, E, Schendel, D, Thorsen, P, Mortensen, PB (2005). Risk factors for autism: perinatal factors, parental psychiatric history, and socioeconomic status. American Journal of Epidemiology 161, 916–925.CrossRefGoogle ScholarPubMed
Lauritsen, MB, Pedersen, CB, Mortensen, PB (2005). Effects of familial risk factors and place of birth on the risk of autism: a nationwide register-based study. Journal of Child Psychology and Psychiatry 46, 963–971.CrossRefGoogle ScholarPubMed
Levy, S, Zoltak, B, Saelens, T (1988). A comparison of obstetrical records of autistic and nonautistic referrals for psychoeducational evaluations. Journal of Autism and Developmental Disorders 18, 573–581.CrossRefGoogle ScholarPubMed
Lichtenstein, P, Carlström, C, Rastam, M, Gillberg, C, Anckarsater, H (2010). The genetics of autism spectrum disorders and related neuropsychiatric disorders in childhood. American Journal of Psychiatry 167, 1357–1363.CrossRefGoogle ScholarPubMed
Lichtenstein, P, Sullivan, PF, Cnattingius, S, Gatz, M, Johansson, S, Carlström, C, Björk, C, Svartengren, M, Wolk, A, Klareskog, L, De Faire, U, Schalling, M, Palmgren, J, Pedersen, NL (2006). The Swedish Twin Registry in the third millennium: an update. Twin Research and Human Genetics 9, 875–882.CrossRefGoogle ScholarPubMed
Limperpoulos, C (2009). Autism spectrum disorders in survivors of extreme prematurity. Clinical Perinatology 36, 791–805.CrossRefGoogle Scholar
Littell, RC, Milliken, GA, Stroup, WW, Wolfinger, RD (1996). SAS System for Mixed Models. SAS Institute, Inc.: Cary, NC.Google Scholar
Losh, M, Childress, D, Lam, K, Piven, J (2008). Defining key features of the broad autism phenotype: a comparison across parents of multiple- and single-incidence autism families. American Journal of Medical Genetics. Part B, Neuropsychiatric Genetics 147B, 424–433.CrossRefGoogle ScholarPubMed
Lundstrom, S, Chang, Z, Kerekes, N, Gumpert, CH, Rastam, M, Gillberg, C, Lichtenstein, P, Anckarsater, H (2011). Autistic-like traits and their association with mental health problems in two nationwide twin cohorts of children and adults. Psychological Medicine 41, 2423–2433.CrossRefGoogle ScholarPubMed
Lundstrom, S, Haworth, CM, Carlström, E, Gillberg, C, Mill, J, Rastam, M, Hultman, CM, Ronald, A, Anckarsater, H, Plomin, R, Lichtenstein, P, Reichenberg, A (2010). Trajectories leading to autism spectrum disorders are affected by paternal age: findings from two nationally representative twin studies. Journal of Child Psychology and Psychiatry 51, 850–856.CrossRefGoogle ScholarPubMed
Magnus, P, Gjessing, HK, Skrondal, A, Skjaerven, R (2001). Paternal contribution to birth weight. Journal of Epidemiology and Community Health 55, 873–877.CrossRefGoogle ScholarPubMed
Maimburg, RD, Vaeth, M (2006). Perinatal risk factors and infantile autism. Acta Psychiatrica Scandinavica 114, 257–264.CrossRefGoogle ScholarPubMed
Markowitz, PI (1983). Autism in a child with congenital cytomegalovirus infection. Journal of Autism and Developmental Disorders 13, 249–253.CrossRefGoogle Scholar
Mason-Brothers, A, Ritvo, ER, Pingree, C, Petersen, PB, Jenson, WR, McMahon, WM, Freeman, BJ, Jorde, LB, Spencer, MJ, Mo, A, Ritvo, A (1990). The UCLA-University of Utah epidemiologic survey of autism: prenatal, perinatal, and postnatal factors. Pediatrics 86, 514–519.CrossRefGoogle ScholarPubMed
O'Brien, WF, Knuppel, RA, Scerbo, JC, Rattan, PK (1986). Birth weight in twins: an analysis of discordancy and growth retardation. Obstetrics and Gynecology 67, 483–486.Google ScholarPubMed
Ozonoff, S, Young, GS, Carter, A, Messinger, D, Yirmiya, N, Zwaigenbaum, L, Bryson, S, Carver, LJ, Constantino, JN, Dobkins, K, Hutman, T, Iverson, JM, Landa, R, Rogers, SJ, Sigman, M, Stone, WL (2011). Recurrence risk for autism spectrum disorders: a Baby Siblings Research Consortium Study. Pediatrics. Published online: 15 August 2011. doi:10.1542/peds.2010-2825.CrossRefGoogle ScholarPubMed
Piven, J, Palmer, P, Landa, R, Santangelo, S, Jacobi, D, Childress, D (1997). Personality and language characteristics in parents from multiple-incidence autism families. American Journal of Medical Genetics. Part B, Neuropsychiatric Genetics 74, 398–411.3.0.CO;2-D>CrossRefGoogle ScholarPubMed
Piven, J, Simon, J, Chase, GA, Wzorek, M, Landa, R, Gayle, J, Folstein, S (1993). The etiology of autism: pre-, peri- and neonatal factors. Journal of the American Academy of Child and Adolescent Psychiatry 32, 1256–1263.CrossRefGoogle ScholarPubMed
Reichenberg, A, Gross, R, Weiser, M, Bresnahan, M, Silverman, J, Harlap, S, Rabinowitz, J, Shulman, C, Malaspina, D, Lubin, G, Knobler, H, Davidson, M, Susser, E (2006). Advancing paternal age and autism. Archives of General Psychiatry 63, 1026–1032.CrossRefGoogle ScholarPubMed
Ronald, A, Happe, F, Dworzynski, K, Bolton, P, Plomin, R (2010). Exploring the relation between prenatal and neonatal complications and later autistic-like features in a representative community sample of twins. Child Development 81, 166–182.CrossRefGoogle Scholar
Schendel, D, Bhasin, TK (2008). Birth weight and gestational age characteristics of children with autism, including a comparison with other developmental disabilities. Pediatrics 121, 1155–1164.CrossRefGoogle ScholarPubMed
Skranes, J, Vangberg, TR, Kulseng, S, Indredavik, MS, Evensen, KA, Martinussen, M, Dale, AM, Haraldseth, O, Brubakk, AM (2007). Clinical findings and white matter abnormalities seen on diffusion tensor imaging in adolescents with very low birth weight. Brain 130, 654–666.CrossRefGoogle ScholarPubMed
Spellacy, WN, Handler, A, Ferre, CD (1990). A case-control study of 1253 twin pregnancies from a 1982–1987 perinatal data base. Obstetrics and Gynecology 75, 168–171.Google ScholarPubMed
Steffenburg, S, Gillberg, C, Hellgren, L, Andersson, L, Gillberg, IC, Jakobsson, G, Bohman, M (1989). A twin study of autism in Denmark, Finland, Iceland, Norway and Sweden. Journal of Child Psychology and Psychiatry 30, 405–416.CrossRefGoogle ScholarPubMed
Stokes, ME, Davis, CS, Koch, GG (2000). Categorical Data Analysis Using the SAS System. SAS Institute Inc.: Cary, NC.Google Scholar
Szatmari, P (2011). Is autism, at least in part, a disorder of fetal programming? Archives of General Psychiatry. Published online: 5 July 2011. doi:10.1001/archgenpsychiatry.2011.99.CrossRefGoogle Scholar
Talbot, GT, Goldstein, RF, Nesbitt, T, Johnson, JL, Kay, HH (1997). Is size discordancy an indication for delivery of preterm twins? American Journal of Obstetrics and Gynecology 177, 1050–1054.CrossRefGoogle ScholarPubMed
Ward, AJ (1990). A comparison and analysis of the presence of family problems during pregnancy of mothers of autistic children and mothers of normal children. Child Psychiatry and Human Development 20, 279–288.CrossRefGoogle ScholarPubMed
Weiss, LA, Arking, DE; Gene Discovery Project of Johns Hopkins and the Autism Consortium, Daly, MJ, Chakravarti, A (2009). A genome-wide linkage and association scan reveals novel loci for autism. Nature 461, 802–808.CrossRefGoogle ScholarPubMed
Weiss, LA, Shen, Y, Korn, JM, Arking, DE, Miller, DT, Fossdal, R, Saemundsen, E, Stefansson, H, Ferreira, MA, Green, T, Platt, OS, Ruderfer, DM, Walsh, CA, Altshuler, D, Chakravarti, A, Tanzi, RE, Stefansson, K, Santangelo, SL, Gusella, JF, Sklar, P, Wu, BL, Daly, MJ (2008). Association between microdeletion and microduplication at 16p11.2 and autism. New England Journal of Medicine 358, 667–675.CrossRefGoogle ScholarPubMed
Zwaigenbaum, L, Szatmari, P, Jones, MB, Bryson, SE, Maclean, JE, Mahoney, WJ, Bartolucci, G, Tuff, L (2002). Pregnancy and birth complications in autism and liability to the broader autism phenotype. Journal of the American Academy of Child and Adolescent Psychiatry 41, 572–579.CrossRefGoogle Scholar