Autism and Pregnancy: What the Research Really Says About Risk Factors
Understanding Autism Risk: Beyond the Headlines
If you're an expecting parent or someone navigating a diagnosis of autism spectrum disorder (ASD) in your family, it's natural to wonder: Why does autism develop? Could something during pregnancy have caused it?
This question has made headlines in recent years, especially as studies suggest links between certain maternal health conditions—like diabetes or infections—and autism in children. But the story is much more complex than a single cause-and-effect headline can capture.
At Philadelphia Integrative Psychiatry, we keep a close eye on emerging research to better understand the nuances of mental health conditions, including autism. While we're far from having all the answers, understanding what truly increases risk—and what doesn’t—helps us better guide families through care and prevention strategies.
A Closer Look at the Research
We reviewed several recent studies exploring maternal health and autism risk, including:
"Familial confounding in the associations between maternal health and autism" (Nature Medicine, 2025)
"Association between autism spectrum disorder and diabetes: systematic review and meta-analysis" (Neuroscience & Biobehavioral Reviews, 2022)
"Is maternal diabetes during pregnancy associated with neurodevelopmental, cognitive and behavioural outcomes in children?" (BMC Pediatrics, 2025)
Here's what these studies tell us—and just as importantly, what they don't.
Diabetes and Autism: Is There a Link?
Several studies have shown that gestational diabetes mellitus (GDM)—a type of diabetes that develops during pregnancy—is associated with increased odds of neurodevelopmental issues, including ADHD and, to a lesser extent, ASD.
A meta-analysis of 24 studies found a modest link between diabetes and ASD (unadjusted odds ratio 1.53) but that link disappeared once researchers controlled for confounding factors like socioeconomic status or other health conditions.
Another large-scale study found that GDM was associated with ADHD symptoms and externalizing behaviors in children, especially between the ages of 4–10. But again, these associations weakened after adjusting for key maternal and environmental factors.
🧠 Dr. Danish’s Take:
"When we see studies linking diabetes or other maternal conditions to autism, it's easy to panic or assign blame. But correlation doesn’t equal causation. What these articles highlight is that genetics and family environment play a huge role—and often explain most of the observed associations."
The Power of Genetics: What the Big Study from Denmark Revealed
Perhaps the most important insight comes from a massive 2025 Danish cohort study of over 1.1 million births.
This study initially showed strong links between many maternal health diagnoses—like diabetes, depression, and even infections—and autism diagnoses in children. But when the researchers adjusted for familial confounding (i.e., shared genes and environment between mother and child), most of these links faded.
Key Findings:
Diabetes during pregnancy was associated with autism (HR 1.19–1.23) before family adjustments.
But in sibling comparisons, where one sibling had exposure and another didn’t, these associations dramatically weakened or disappeared.
This suggests that shared genetics or family environments—not pregnancy exposures alone—are driving much of the observed autism risk.
🧠 Dr. Danish’s Take:
“In clinical psychiatry, we often talk about the ‘multiple hit hypothesis.’ Genetic vulnerability may create the conditions—but it's often the interaction with environmental stressors that influences the final outcome. That’s exactly what this study supports.”
Making Sense of Conflicting Data
So why do some studies still show a link?
Here’s what can cause differences:
Small sample sizes or poor control for confounders can inflate associations.
Different definitions of autism and diabetes across studies.
Shorter follow-up periods, which may miss later-onset symptoms.
When taken together, the more rigorous the study (especially with family-based designs), the less convincing the link becomes between pregnancy exposures like GDM and autism itself.
What This Means for You
If you or someone you love is navigating a diagnosis, please remember:
Autism is not caused by one thing. It's a neurodevelopmental condition shaped by many factors—genetic, environmental, and biological.
Being informed reduces fear. Understanding the real risks helps families make empowered, evidence-based decisions.
We're here to help. Whether you're concerned about developmental milestones, pregnancy risks, or managing a diagnosis, our team offers compassionate, integrated care for your whole family.
Getting in Touch with Dr. Danish and His Team
At Philadelphia Integrative Psychiatry, we pride ourselves on staying current with the latest science—while delivering personalized, compassionate care. We don’t just look at diagnoses. We look at people. Our approach integrates biology, psychology, and family context to guide treatment and support.
If you’re concerned about autism or developmental challenges, reach out. Our experienced team is here to evaluate, support, and partner with you—every step of the way.
Related Blog Links
https://phillyintegrative.com/blog/how-nac-may-help
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Disclaimer: This guide is for informational purposes only and not a substitute for medical advice. Any treatment—whether a supplement, medication, procedure, injection, therapy, or device—carries potential risks, especially when used in excess or by individuals with certain medical conditions or genetic predispositions. Always consult a qualified healthcare provider before starting any treatment.
