Scientific publications from the ABC Study
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Here is a selection of research findings and scientific publications from the Autism Study.
Diet in pregnancy
Data from the Autism Study and MoBa have been used to study whether autism risk in children is affected by maternal diet during pregnancy. The risk of having children with autism was 40 % lower among mothers who took folic acid supplements early in pregnancy compared with mothers who did not take these supplements. Folic acid supplements are recommended for all women who are planning to conceive because it prevents spina bifida. The children had a lower risk of autism if their mothers took the supplements in the period from 4 weeks before conception to 8 weeks after the start of the pregnancy. The finding does not prove that folic acid can prevent autism, but it supports current recommendations to take the supplement. The finding also supports the recommendation that women should start taking folic acid supplements before they conceive.
Infections during pregnancy
Researchers have used blood samples taken from mothers in MoBa to study whether infections during pregnancy affect the risk of having children with autism. They found no association for infections that are considered unfavourable in pregnancy, i.e. influenza, toxoplasmosis, rubella and cytomegalovirus. There was an association between high levels of antibodies to herpes simplex virus type 2 and autism risk. This finding must be confirmed by other studies before the herpes virus is discussed as a possible risk factor for autism.
Early identification of autism
There is a great demand for questionnaires or tests that can detect autism early among children. When these tools are used systematically to identify autism, it is called screening. In MoBa's questionnaires at 18 and 36 months, screening for autism was included in the questionnaires. This proved to be ineffective. The children identified through screening were mainly children with both autism and developmental delays. The majority of children with autism have intellectual skills within the normal range, and were not identified by screening. We therefore have little confidence that early screening is effective.
Prevalence and diagnosis
In the medical record reviews, we assessed the quality of autism diagnoses in the Norwegian healthcare system. This seems to be good. If a doctor or psychologist made an autism diagnosis, 95% of the diagnoses were well documented in the medical records. The records show that the children fit the diagnostic criteria for autism. We have compared these findings with health registry data that apply to the entire population. The proportion with autism diagnoses in MoBa resembles the rest of the population. We have estimated that approximately 1.5% of children in Norway are diagnosed with autism before they reach adulthood.
Genetic analyses
Exome sequencing has been performed for approximately 150 mother-father-child trios from the Autism Study. This is a mapping of all genes that encode proteins in the body. The data are part of the Autism Sequencing Consortium, which has collected genetic data from many different autism studies. The results were published in 2020 in the journal Cell (see list of scientific articles below). Genetic data are also used in the PsychGen-project. PsychGen is a Norwegian collaboration project that studies genetic causes of autism and other developmental disorders and mental disorders.
Environmental contaminants
Data from the Autism Study are used in the NeuroTox project, which studies the significance of environmental contaminants in pregnancy for the risk of developmental disorders and neurological diseases among children.
Scientific publications from the Autism Study
- Stoltenberg C, Schjolberg S, Bresnahan M, Hornig M, Hirtz D, Dahl C, Lie KK, Reichborn-Kjennerud T, Schreuder P, Alsaker E, Øyen AS, Magnus P, Surén P, Susser E, Lipkin WI, and the ABC Study Group. The Autism Birth Cohort (ABC): A paradigm for gene-environment timing research. Mol Psychiatry 2010; 15(7): 676-680.
- Surén P, Bakken IJ, Aase H, Chin R, Gunnes N, Lie KK, Magnus P, Reichborn-Kjennerud T, Schjølberg S, Øyen AS, Stoltenberg C. Autism spectrum disorder, ADHD, epilepsy and cerebral palsy in Norwegian children. Pediatrics 2012; 130(1): e152-158.
- Surén P, Roth C, Bresnahan M, Haugen M, Hornig M, Hirtz D, Lie KK, Lipkin WI, Magnus P, Reichborn-Kjennerud T, Schjølberg S, Davey Smith G, Øyen AS, Susser E, Stoltenberg C. Association between maternal use of folic acid supplements and risk of autism in children. JAMA 2013; 309(6): 570-577.
- Surén P, Stoltenberg C, Bresnahan M, Hirtz D, Lie KK, Lipkin WI, Magnus P, Reichborn-Kjennerud T, Schjølberg S, Susser E, Øyen AS, Li L, Hornig M. Early growth patterns in children with autism. Epidemiology 2013; 24(5): 660-670.
- Nilsen RM, Surén P, Gunnes N, Alsaker ER, Bresnahan M, Hirtz D, Hornig M, Lie KK, Lipkin WI, Reichborn-Kjennerud T, Roth C, Schjølberg S, Davey Smith G, Susser E, Vollset SE, Øyen AS, Magnus P, Stoltenberg C. Analysis of self-selection bias in a population-based cohort study of autism spectrum disorders. Paediatr Perinat Epidemiol 2013; 27(6): 553-563.
- Surén P, Bakken IJ, Lie KK, Schjølberg S, Aase H, Reichborn-Kjennerud T, Magnus P, Øyen AS, Svendsen BK, Aaberg KM, Andersen GL, Stoltenberg C. Fylkesvise forskjeller i registrert forekomst av autism, AD/HD, epilepsi og cerebral parese i Norge. Tidsskrift for Den norske legeforening 2013: 133(18); 1929-1934.
- Stenberg N, Bresnahan M, Gunnes N, Hirtz D, Hornig M, Lie KK, Lipkin WI, Lord C, Magnus P, Reichborn-Kjennerud T, Schjølberg S, Surén P, Susser E, Svendsen BK, von Tetzchner S, Øyen AS, Stoltenberg C. Identifying children with autism spectrum disorder at 18 months in a general population sample. Paediatr Perinat Epidemiol 2014; 28(3): 255-262.
- Surén P, Gunnes N, Roth C, Bresnahan M, Hornig M, Hirtz D, Lie KK, Lipkin WI, Magnus P, Reichborn-Kjennerud T, Schjølberg S, Susser E, Øyen AS, Davey Smith G, Stoltenberg C. Parental obesity and risk of autism spectrum disorder. Pediatrics 2014; 133: 1-11.
- Bresnahan M, Hornig M, Schultz AF, Gunnes N, Hirtz D, Lie KK, Magnus P, Reichborn-Kjennerud T, Roth C, Schjølberg S, Stoltenberg C, Surén P, Susser E, Lipkin WI. Association of maternal report of infant and toddler gastrointestinal symptoms with autism: Evidence from a prospective birth cohort. JAMA Psychiatry 2015; 72(5): 466-474.
- Mahic M, Mjaaland S, Bøvelstad HM, Gunnes N, Susser E, Bresnahan M, Øyen A-S, Levin B, Che X, Hirtz D, Reichborn-Kjennerud T, Schjølberg S, Roth C, Magnus P, Stoltenberg C, Surén P, Hornig M, Lipkin WI. 2017. Maternal immunoreactivity to herpes simplex virus 2 and risk of autism spectrum disorder in male offspring. mSphere 2017; 2(1): e00016-17.
- Mahic M, Che X, Susser E, Levin B, Reichborn-Kjennerud T, Magnus P, Stoltenberg C, Chauhan L, Briese T, Bresnahan M, Surén P, Hornig M, Mjaaland S, Lipkin WI. Epidemiological and serological investigation into the role of gestational maternal influenza virus infection and autism spectrum disorders. mSphere 2017; 2(3): e00159-17.
- Hornig M, Bresnahan MA, Che X, Schultz AF, Ukaigwe JE, Eddy ML, Hirtz D, Gunnes N, Lie KK, Magnus P, Mjaaland S, Reichborn-Kjennerud T, Schjølberg S, Øyen AS, Levin B, Susser ES, Stoltenberg C, Lipkin WI. Prenatal fever and autism risk. Mol Psychiatry 2018; 23(3): 759-766.
- Surén P, Saasen-Havdahl A, Bresnahan M, Hirtz D, Hornig M, Lord C, Reichborn-Kjennerud T, Schjølberg S, Øyen AS, Magnus P, Susser E, Lipkin WI, Stoltenberg C. Sensitivity and specificity of early screening for autism. BJPsych Open 2019; 5: e41, 1–8. doi: 10.1192/bjo.2019.34.
- Surén P, Havdahl A, Øyen AS, Schjølberg S, Reichborn-Kjennerud T, Magnus P, Bakken IJ, Stoltenberg C. Diagnostisering av autismespekterforstyrrelser hos barn i Norge. Tidsskrift for Den norske legeforening 2019; 139(14); doi: 10.4045/tidsskr.18.0960.
- Stenberg N, Schjølberg S, Shic F, Volkmar F, Øyen AS, Besnahan M, Svendsen BK, von Tetzchner S, Thronæs NT, Macari S, Cicchetti DV, Chawarska K, Surén P, Øien RA. Functional outcomes of children identified early in the developmental period as at risk for ASD utilizing the Norwegian Mother, Father and Child Cohort Study (MoBa). J Autism Dev Disord 2020; doi: 10.1007/s10803-020-04539-8.
- Satterstrom FK, Kosmicki JA, Wang J, et al. Large-scale exome sequencing study implicates both developmental and functional changes in the neurobiology of autism. Cell 2020; 180(3): 568-584.e23. doi: 10.1016/j.cell.2019.12.036.
