Project 460720

Austism spectrum disorder (ASD) affects 1 in 60 Canadian children. ASD manifests as challenges in social interaction, speech and nonverbal communication, often with restricted and repetitive behaviours. Why ASD occurs is not known, but is thought to be due to both genetic and environmental factors, including maternal metabolic factors like diabetes mellitus, obesity and high blood pressure, as well as infant factors like premature birth and low birthweight. The relation between pre-pregnancy maternal sugar levels and the risk of ASD is largely unknown, including among women without DM, who nevertheless, can have an elevated blood sugar level. Blood hemoglobin A1c is an inexpensive, readily available blood test that measures average blood sugar levels. We will use existing large healthcare datasets to study about 60,000 women who gave birth in Ontario from 2007-18, permitting us to follow each liveborn child to age 4 years. We intend to apply our findings to better understand if A1c can identify women at higher risk having a child with ASD, and potentially reduce the risk of these important outcomes. We have an experienced, cooperative team of scientists and clinicians, to ensure that the existing data are analyzed and interpreted in a meaningful manner. We will offer clinicians and scientists a novel, powerful, and clear expression of the interaction between pre-pregnancy A1c and factors like maternal pre-pregnancy body mass index, diabetes & high blood pressure, as well as infant birthweight and timing of birth.