Autism spectrum disorders are more than four times as likely to be diagnosed in children born to obese women with diabetes compared to children of healthy weight mothers without diabetes. "We have long known that obesity and diabetes aren't good for mothers' own health," says study leader Xiaobin Wang, MD, ScD, MPH, the Zanvyl Krieger Professor in Child Health at the Bloomberg School and director of the Center on the Early Life Origins of Disease. "Now we have further evidence that these conditions also impact the long-term neural development of their children".

Autism spectrum disorder is a neuro developmental condition characterized by severe deficits in socialization, verbal and nonverbal communication and repetitive behaviors. For the study, the researchers analyzed 2,734 mother-child pairs, a subset of the Boston Birth Cohort recruited at the Boston Medical Center at birth between 1998 and 2014. They identified 102 children who were diagnosed with autism spectrum disorder over the course of the study. Those children with mothers who had diabetes and were obese were more than four times as likely to develop autism compared to children born to normal weight mothers without diabetes, they found.

Previous studies had suggested a link between maternal diabetes and autism, but this is believed to be the first to look at obesity and diabetes in tandem as potential risk factors. Along with pre-conception diabetes, children of obese mothers who developed gestational diabetes during pregnancy were also at a significantly higher risk of being diagnosed with autism.

Previous research suggests maternal obesity may be associated with an inflammation in the developing fetal brain. Other studies suggest obese women have less folate, a B-vitamin vital for human development and health.

The researchers say that women of reproductive age who are thinking about having children need to not only think about their obesity and diabetes status for their own health, but because of the implications it could have on their children. "In order to prevent autism, we may need to consider not only pregnancy, but also pre-pregnancy health," Fallin says.

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