B3367 - Maternal nutritional status in pregnancy and offspring Autism Spectrum Disorder a social perspective - 21/09/2019

B number: 
B3367
Principal applicant name: 
Alastair Leyland | University of Glasgow (UK)
Co-applicants: 
Ms Catherine Friel
Title of project: 
Maternal nutritional status in pregnancy and offspring Autism Spectrum Disorder: a social perspective
Proposal summary: 

What a mother eats during pregnancy has previously been established to programme their infants health in later live, even tracking through to adulthood. However, despite compelling evidence to support foetal programming of physical health, neurodevelopment has remained understudied. Recently, autism has gained increased attention within this field of research. Although largely caused by genetic factors, it is now estimated that approximately 20% of the risk of developing autism relates to environmental factors, of which nutrition is a main focus. Preliminary evidence indicates that the risk of developing autism may be reduced through consumption of a nutritionally adequate diet or nutritional supplements. Furthermore, the presence of social patterning is unknown. Health inequities are observed in numerous health outcomes as low socioeconomic position groups experience more adversity including poorer diet quality. Thus, it is possible that, where an association existed between maternal diet and their child’s risk of autism, it may also be socially patterned.

Two datasets will be compared for this project, ALSPAC and a second dataset called the Norwegian Mother and Child Cohort Study. The data from each cohort will be analysed in the same way.
This project will apply statistical methods that estimate if there is an association between maternal nutritional intake during pregnancy and the child’s risk of developing autism. The project will apply ‘causal methods’ which are statistical methods which better estimate causal relationships from observation data when compared to conventional methods with measure ‘association’. A key way in which this occurs is through adjusting for confounders which vary over time, such as early infant nutrition. Both pregnancy and early infant nutrition such as breastfeeding, complementary feeding and nutrition in the early years have been associated with neurodevelopment and so the effects measured in pregnancy may be further altered by nutrition consumed in childhood. Lastly, results will be stratified by socioeconomic position to more clearly assess the presence and the degree of social patterning in this relationship.

Impact of research: 
This project will inform prevention strategies by addressing three main research gaps; estimating causality, identifying critical periods and exploring health inequalities. Firstly, this research will estimate the causal association between nutritional status in pregnancy and the risk of autism in offspring. In doing so, it will address the lack of evidence supporting a healthy diet in pregnancy. Furthermore, it is well recognised that misinformation in pregnancy is common and that dietary information may be more affected than information regarding general health. Yet at present, there is limited evidence on the impact of obesity, weight gain and diet in pregnancy on outcomes in offspring. Secondly, by identifying critical periods we can target prevention strategies more effectively. This project measures the impact of nutritional status in pregnancy, breast or formula feeding and infant dietary intake. All of which may have independent or accumulative effects on autism. Through contributing to the evidence base on a healthy diet in pregnancy this project will feed into a larger pool of evidence that informs national guidelines such as NICE: Maternal and Child Nutrition (PH11). Thirdly, exploring health inequalities may also help to target prevention strategies to those most in need. The UK Government stipulated that proportional universalism should be incorporated into prevention strategies however, few studies measure health inequalities. By evidencing health inequalities this project may indicate where to target resources and it may promote confidence in dietitians to open-up discussion on health inequalities. Through contributing to the evidence base on a healthy diet in pregnancy this project will feed into a larger pool of evidence that informs national guidelines such as NICE: Maternal and Child Nutrition (PH11).
Date proposal received: 
Friday, 6 September, 2019
Date proposal approved: 
Friday, 6 September, 2019
Keywords: 
Epidemiology, Behaviour - e.g. antisocial behaviour, risk behaviour, etc., Developmental disorders - autism, Cognitive impairment, Speech/language problem, Statistical methods, Birth outcomes, BMI, Nutrition - breast feeding, diet, Offspring, Speech and language, Statistical methods, Cohort studies - attrition, bias, participant engagement, ethics, Childhood - childcare, childhood adversity, Cognition - cognitive function, Communication (including non-verbal), Development, Epigenetics, Genetic epidemiology, Mothers - maternal age, menopause, obstetrics