Objectives
Although studies have reported associations between infections and febrile episodes during gestation and both autism and intellectual disability (ID) in offspring, results are mixed and limited to specific populations. We examined the association between maternal inpatient diagnosis of infection and childhood risk of autism, ID and epilepsy in a population-based birth cohort.
Methods
This retrospective cohort included California singleton births between 1/1/1991-12/31/2008 that survived the first year of life (n=8,618,171). Infection during pregnancy was defined using ICD-9-CM codes from any maternal hospitalization and codes with fewer than 50 events were excluded. Birth files were merged with records from the California Department of Developmental Services (DDS) for children receiving care between 1/1/1991-12/31/2012, identifying 42,998 with autism, 45,546 with ID and 2,507 with epilepsy. Outcomes were defined by the DDS using standardized assessments and ICD-9-CM codes. Multinomial logistic regression models calculated relative risks (RRs) and 95% confidence intervals (CIs) for autism, ID or epilepsy in children according to maternal infection status, controlling for maternal age, race/ethnicity, educational attainment, payer, parity and birth year. Additional models using sub-categories of the predictor explored the effect of type, site, fever propensity and timing of infection on outcomes of interest.
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