Fièvre prénatale et risque d'autisme

Aperçu: G.M.

Certaines études suggèrent que l'infection prénatale augmente le risque de "troubles du spectre de l'autisme" (TSA). Cette étude a été entreprise dans une cohorte prospective en Norvège pour examiner si nous pouvions trouver des preuves pour soutenir une association de l'apparition prénatale de la fièvre, une manifestation commune d'infection, avec un risque de TSA. Des questionnaires prospectifs ont fourni des données sur l'exposition maternelle.

Le risque a augmenté nettement avec l'exposition à trois épisodes de fièvre ou plus après 12 semaines de gestation.  

Le risque de TSA semble augmenter avec la fièvre maternelle, en particulier au deuxième trimestre.  

Le risque augmente proportionnellement de degré avec une exposition à de multiples fièvres après une grossesse de 12 semaines.  

Ces résultats confortent le rôle de l'infection maternelle gestationnelle et des réponses immunitaires innées à une infection dans la pathogenèse d'au moins certains cas de TSA. 

Mol Psychiatry. 2017 Jun 13. doi: 10.1038/mp.2017.119.

Prenatal fever and autism risk

Hornig M^1,2, Bresnahan MA^2,3, Che X¹, Schultz AF¹, Ukaigwe JE¹, Eddy ML¹, Hirtz D⁴, Gunnes N⁵, Lie KK⁵, Magnus P⁵, Mjaaland S⁵, Reichborn-Kjennerud T^5,6, Schjølberg S⁵, Øyen AS^5,7, Levin B⁸, Susser ES^2,3, Stoltenberg C^5,9, Lipkin WI^1,2,10.

Author information

1

Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, NY, USA.

2

Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.

3

New York State Psychiatric Institute, New York, NY, USA.

4

National Institute of Neurological Disorders and Stroke, National Institutes of Health, Rockville, MD, USA.

5

Norwegian Institute of Public Health, Oslo, Norway.

6

Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.

7

Lovisenberg Diakonale Sykehus, Nic Waals Institutt, Oslo, Norway.

8

Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA.

9

Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.

10

Departments of Pathology and Neurology, Columbia University College of Physicians and Surgeons, New York, NY, USA.

Abstract

Some studies suggest that prenatal infection increases risk of autism spectrum disorders (ASDs). This study was undertaken in a prospective cohort in Norway to examine whether we could find evidence to support an association of the prenatal occurrence of fever, a common manifestation of infection, with ASD risk. Prospective questionnaires provided maternal exposure data; case status was established from clinical assessments and registry linkages. In a large, prospectively ascertained cohort of pregnant mothers and their offspring, we examined infants born ⩾32 weeks for associations between fever exposure in each trimester and ASD risk using logistic regression. Maternal exposure to second-trimester fever was associated with increased ASD risk, adjusting for presence of fever in other trimesters and confounders (adjusted odds ratio (aOR), 1.40; 95% confidence interval, 1.09-1.79), with a similar, but nonsignificant, point estimate in the first trimester. Risk increased markedly with exposure to three or more fever episodes after 12 weeks' gestation (aOR, 3.12; 1.28-7.63). ASD risk appears to increase with maternal fever, particularly in the second trimester. Risk magnified dose dependently with exposure to multiple fevers after 12 weeks' gestation. Our findings support a role for gestational maternal infection and innate immune responses to infection in the pathogenesis of at least some cases of ASD.Molecular Psychiatry advance online publication, 13 June 2017; doi:10.1038/mp.2017.119.

PMID:28607458

DOI:10.1038/mp.2017.119