Office of Epidemiology and Research, Division of Research

Advancing Applied MCH Research

Early life origins of ASD: Role of maternal and cord blood metabolome, placental histology and fetal growth trajectory

Funded Projects Search


Project Number: UJ2MC31074
Grantee: Johns Hopkins University
Department/Center: Population, Family & Repro Hlt Bloomberg School of Public Health
Project Date: 09/01/2017
Principal Investigator: Xiaobin Wang

Final Report



  • Women/Maternal
  • Perinatal/Infancy (0-12 months)
  • Toddlerhood (13-35 months)
  • Early Childhood (3-5 years)
  • Middle Childhood (6-11 years)
  • Adolescence (12-18 years)
  • Young Adulthood (19-25 years)

Targeted/Underserved Population

  • Low-income
  • African American
  • Hispanic/Latino
  • Asian/Pacific Islander


Problem: Autism Spectrum Disorder (ASD) affect 1 in 68 U.S. children. Early identification and prevention are key to reducing the population burden of ASD. Growing evidence supports fetal or even preconception origins of ASD, yet existing findings are mostly derived from case-control or retrospective studies. No adequately powered birth cohort studies have prospectively ascertained early life risk factors and biomarkers for ASD in US minorities. Goals and Objectives: This proposal aims to address the areas of interest outlined by HRSA- 17- 014 (Autism Longitudinal Data Project): "Genomic, metabolic, and inflammatory markers for screening"; "minority population"; and "maternal and perinatal origins". We will leverage the exceptional resources of the Boston Birth Cohort (BBC) to accomplish the following aims in a time and cost-efficient fashion: Aim 1. Examine the role of maternal and cord blood metabolomes in ASD; Aim 2. Examine placental histological findings in relation to the risk of ASD; Aim 3. Examine in utero fetal growth patterns in relation to the risk of ASD; Aim 4. Integrate multi-dimensional data to develop early prediction models and test interventions; and Aim 5. Provide leadership in education, training and dissemination. Methods: We will apply cutting-edge metabolomic technologies, which allow for a highthroughput and comprehensive characterization of all major circulating metabolites, reflecting the biological state of genetic and environmental interactions. In addition, we will examine placental histological findings as assessed by highly experienced placental pathologists, and fetal longitudinal growth patterns as assessed by a series of prenatal ultrasound exams. We will also use a novel approach that combines computational systems modeling with empirical data from the BBC to understand the complex interplay of pre-, peri-, and post-natal factors in ASD; determine key modifiable factors that most impact the subsequent development of ASD; and test the intervention effects by modifying these factors to different degrees under a variety of scenarios in a computer environment. Healthy People 2020 Objective(s): To our knowledge, this will be by far the largest prospective birth cohort study on ASD and associated developmental disabilities in a U.S. urban predominantly low-income minority population. This study is unprecedented due to the integration of maternal and cord blood metabolome with a prospective birth cohort, and has a high likelihood to discover novel maternal and cord blood biomarkers, which in turn will be much useful to develop screening algorithms to identify newborns at higher risk for ASD. By integrating a myriad of multi-level longitudinal data and dissecting the complex causal pathways that contribute to ASD at critical early developmental windows, this study may lead to a transformation in the way in which clinical and public health services are organized and delivered. This will ultimately lead to the development of cost-effective interventions to halt or reverse the ASD risk trajectory during early developmental periods when interventions may have the greatest life-long impact. The establishment of these novel approaches amongst high-risk urban U.S. populations will be of key importance for lowering the population burden of ASD.


Listed is descending order by year published.

6. Ji Y, Hong X, Wang G, Chatterjee N, Riley AW, Lee LC, Surkan P, Bartell TR, Zuckerman B, Wang X. A prospective birth cohort study on early childhood lead levels and attention deficit hyperactivity disorder: new insight on sex differences. J of Pediatrics. 2018. Aug. 199;124-34.e8. DOI:

Cheng TL, Mistry KB, Wang G, Zuckerman B, Wang X. Folate Nutrition Status in Mothers of the Boston Birth Cohort, Sample of a US Urban Low-Income Population. Am J Public Health. 2018 Apr 19:e1-e9. doi: 10.2105/AJPH.2018.304355. PMID: 29672150

Lauren O, Ji Y, Riley AW, Wang X. Maternal psychosocial stress and children’s ADHD diagnosis: a prospective birth cohort study. J Psychosom Obs Gyn 2018 May 23:1-9. doi: 10.1080/0167482X.2018.1468434. [Epub ahead of print]

Zhang M, Mueller NT, Wang H, Hong X, Appel LJ, Wang X. Maternal exposure to ambient pm2.5 during pregnancy and the risk for high blood pressure in childhood: findings from the Boston Birth Cohort. Hypertension. May 2018. DOI: 10.1161/HYPERTENSIONAHA.117.10944.

9. Surkan PJ, Dong L, Ji Y, Hong X, Ji H, Wang X. Paternal involvement and support and risk of preterm birth: Findings from the Boston Birth Cohort. J Psychosom Obs Gyn, 2017 Nov 16:1-9. doi: 10.1080/0167482X.2017.1398725. PMID:29144191

Brucato M, Ladd-Acosta C, Li M, Caruso D, Hong X, Kaczaniuk J, Stuart EA, Fallin MD, Wang X. Prenatal exposure to fever is associated with Autism Spectrum Disorder in the Boston Birth Cohort. Autism Research. First published: 11 August 2017. DOI: 10.1002/aur.1841

Bustamante-helfrich B, Chilukuri N, He H, Cerda SR, Hong X, Wang G, Pearson C, Burd I, Wang X. Maternal vascular malperfusion of the placental bed associated with hypertensive disorders in the boston birth cohort. Placenta 2017 Apr;52:106-113 doi: 10.1016/j.placenta.2017.02.016 PMID: 28454692

Ji Y, Riley AW, Lee LC, Volk H, Hong X, Wang G, Angomas R, Stivers T, Wahl A, Ji H, Bartell TR, Burd I, Paige D, Fallin MD, Zuckerman B, Wang X. A prospective birth cohort study on maternal cholesterol levels and offspring attention deficit hyperactivity disorder: new insight on sex differences. Brain Sci. 2017 Dec 23;8(1). pii: E3. doi: 10.3390/brainsci8010003.

Raghavan R, Riley AW, Volk H, Caruso D, Hironaka L, Sices L, Hong X, Wang G, Ji Y, Brucato M, Wahl A; Stivers T, Pearson C, Zuckerman B, Stuart EA, Landa R, Fallin DM, Wang X. Maternal multivitamin intake, plasma folate and vitamin B12 levels and ASD risk in offspring. Pediatrics and Perinatal Epidemiology. 2017 Oct 6. doi: 10.1111/ppe.12414. [Epub ahead of print]

Li M, Fallin MD, Riley A, Landa R, Walker SO, Silverstein M, Caruso D, Pearson C, Kiang S, Dahm JL, Hong X, Wang G, Wang MC, Zuckerman B, Wang X. The Association of maternal obesity and diabetes with autism and other developmental disabilities. Pediatrics. 2016 Feb;137(2):e20152206. doi: 10.1542/peds.2015-2206. Epub 2016 Jan 29


Autism Spectrum Disorder, Early Life Origins, Metabolome, Placenta

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