Risk for Autism Spectrum Disorder Increased in Children of Parents With Mood Disorders

pregnant women sit on the bed and feel depression at home
Maternal affective and depressive disorders may increase the risk for autism spectrum disorder in children, while exposure to disorders in fathers alone does not appear to a risk factor.

There is an increased risk for autism spectrum disorder (ASD) in the children of parents with mood disorders, according to study results published in the Journal of Affective Disorders.

Getinet Ayano, PhD candidate of the School of Social Sciences, the University of Queensland, Indooropilly, Australia, and colleagues conducted a systematic literature review and meta-analysis using the electronic databases EMBASE, PubMed, PsychINFO, and Scopus to investigate the risk for ASD in children of parents with mood disorders.

The investigators selected 9 observational studies from an original group of 4308 articles identified by the literature search. Of these, 2 were cohort studies and the other 7 were case-control studies. The relative risk (RR) for having ASD was significantly higher in children whose parents had affective disorders (RR, 1.65). In case-control studies, the pooled RR was 1.69; in the 2 cohort studies, it was 1.47. The stratified meta-analysis demonstrated an increased risk for ASD in the children of parents with depressive disorder (RR, 1.37) and bipolar disorder (RR, 1.87).

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Subgroup analysis showed a significantly higher risk for ASD in the children of  mothers with affective and depressive disorders (RR, 1.67 and 1.62, respectively) but no association with ASD in the children of fathers with affective and depressive disorders (RR, 1.32 and 0.88, respectively).

The researchers included a few possible explanations for the association between parental mood disorders and ASD in offspring. One is that affective disorders such as bipolar and depressive disorders may share a genetic etiology with ASD or that epigenetic modifications may lead to a greater risk for ASD in the offspring of individuals with mood disorders. Another possible explanation is that in utero exposure to stress, mental health problems, and/or substance use may affect offspring neurodevelopment.

Limitations of this study include the inability to adjust for some confounders, the significant heterogeneity across the studies for overall affective disorders, and the inability to guarantee that parental mood disorders preceded the diagnosis of ASD in children.

The researchers maintained that the results of their research suggest that the parental sex difference in the risk for ASD and mood disorders in parents requires further investigation. Further research is also necessary to determine which specific mood disorder is most likely to be associated with ASD in offspring. Additional studies should involve well-designed, large population-based cohort studies to confirm the findings of this meta-analysis.


Ayano G, Maravilla JC, Alati R. Risk of autistic spectrum disorder in offspring with parental mood disorders: a systematic review and meta-analysis. J Affect Disord. 2019;248:185-197.