Funded Projects

(SDAS) Genitourinary Infections During Pregnancy and Risk of Epilepsy, Autism, and ADHD

Grantee: University of South Carolina Research Foundation
Principal Investigator: Joshua Russell Mann
Project Number: R40MC11277
Project Date: 2/1/2009

Final Report

(SDAS) Genitourinary Infections During Pregnancy and Risk of Epilepsy, Autism, and ADHD Final Report (PDF)

Age group(s)

• Women/Maternal
• Prenatal
• Perinatal/Infancy (0-12 months)
• Toddlerhood (13-35 months)
• Early Childhood (3-5 years)
• Middle Childhood (6-11 years)

Abstract

The overall goal of this project is to answer the research question: Do maternal genitourinary (GU) infections during pregnancy result in an increased risk for epilepsy, autism spectrum disorders (ASD), and attention deficit hyperactivity disorder (ADHD) in children? In order to answer the research question we will analyze data from a cohort of over 152,000 Medicaid maternal-child pairs in a retrospective cohort design. The study will examine maternal GU infections during the prenatal period, and their association with epilepsy, ASD, and ADHD in children. GU infections will include sexually transmitted diseases (trichomoniasis, gonorrhea, and Chlamydia trachomatis), infections associated with intercourse (urinary tract infection) and some possibly associated with sexual activity (vaginitis, cervicitis, and candidiasis). Previous research by the study team has identified associations between maternal GU infections and the outcomes of mental retardation/developmental delay and cerebral palsy. These findings are consistent with other research demonstrating an association between maternal infections and neurologic outcomes in children. A major strength of this study is the large sample size available for analysis. Another notable strength is the ability to link mother and child files that incorporate medical diagnoses and prescription information as well as childhood data. We will utilize pharmacy billing records to identify women who received appropriate treatment for GU infection, and examine treatment as a modifier of the effect of infection. Our use of prospectively collected data alleviates the potential problem of bias in reporting GU infections in relation to childhood outcomes. This research directly addresses MCHB Strategic Research Issue #IV, Promoting the Healthy Development of MCH Populations. The benefit of this research is to provide information about the impact of treated and untreated GU infections on fetal and infant outcomes. There is potential for prevention if untreated infections (but not treated ones) are associated with adverse outcomes. Medicaid program recipients are likely to directly benefit from this project since the findings can be used to inform prevention and treatment.

Publications

Listed is descending order by year published.

Griffith MI, Mann JR, McDermott S. The risk of intellectual disability in children born to mothers with preeclampsia or eclampsia with partial mediation by low birth weight. Hypertens Pregnancy. 2011;30(1):108-115.

Mann JR, McDermott S, Griffith MI, Hardin J, Gregg A. Uncovering the complex relationship between pre-eclampsia, preterm birth and cerebral palsy. Paediatr Perinat Epidemiol. 2011 Mar;25(2):100-110.

Mann JR, McDermott S, Bao H, Hardin J, Gregg A. Pre-eclampsia, birth weight, and autism spectrum disorders. J Autism Dev Disord. 2010 May;40(5):548-554.

McDermott S, Mann JR, Wu J. Maternal genitourinary infection appears to synergistically increase the risk of epilepsy in children of women with epilepsy. Neuroepidemiology. 2010 Feb;34(2):117-122.