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Neurodevelopmental disorders in children born to mothers involved in maternal motor vehicle crashes

Pediatric Research (2024)Cite this article

Abstract

Background

To evaluate the association between maternal MVCs during pregnancy and neurodevelopmental disorders (NDDs, including intellectual disability, ADHD, ASD, and infantile cerebral palsy) in children.

Methods

This population-based cohort of live births in Taiwan was analyzed, comparing children born to mothers involved in MVCs during pregnancy with those without such exposure. Children were linked to the insurance database to identify the possible diagnosis of NDDs. The Cox proportional hazards regression model was used to estimate the relative hazards.

Results

A total of 19,277 children with maternal MVCs and 76,015 children without exposure were included. Children exposed to maternal MVCs during the first two trimesters or whose mothers sustained mild to severe injuries showed a higher risk of intellectual disability. Severe maternal injuries also increased the risk of infantile cerebral palsy (aHR = 3.86; 1.27–11.78). MVCs in the third trimester, or mild maternal injuries, were associated with a higher risk of ASD (third trimester: aHR = 1.40; 1.04–1.87; mild injuries: aHR = 1.38; 1.09–1.74).

Conclusion

Children exposed to maternal MVCs with severe injuries had a higher risk of intellectual disability and cerebral palsy. Third-trimester exposure may increase the risk of ASD. However, these findings should be interpreted cautiously as genetic factors may contribute to the observed association.

Impact

  • There is some evidence linking maternal MVCs during pregnancy to the development of neurodevelopmental disorders in children.

  • Children of mothers with severely injured were more likely to suffer from infantile cerebral palsy and intellectual disability.

  • The risk of autism spectrum disorder is higher in children whose mothers are involved in MVCs during the late stage of pregnancy, and there is also an increased risk of intellectual disability during the first two trimesters.

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Acknowledgements

We are grateful to Health Data Science Center, National Cheng Kung University Hospital for proving administrative and technical support.

Funding

This study was supported by a grant from the Ministry of Science and Technology (MOST 109-2314-B-006 -044 -MY3 and MOST 111-2917-I-006-002). The funder has no role in conducting and submitting this work.

Author information

Author notes

  1. These authors contributed equally: Kuo-Sheng Tsai, Chung-Yi Li.

Authors and Affiliations

  1. Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Ya-Hui Chang, Yu-Wen Chien, Tsung-Hsueh Lu & Chung-Yi Li

  2. Emergency Department, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan

    Ya-Hui Chang

  3. Department of Obstetrics and Gynecology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Chiung-Hsin Chang

  4. Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan

    Ping-Ling Chen

  5. Department of Psychiatry, School of Medicine College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

    Cheng-Fang Yen

  6. Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

    Cheng-Fang Yen

  7. College of Professional Studies, National Pingtung University of Science and Technology, Pingtung, Taiwan

    Cheng-Fang Yen

  8. Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan

    Hung-Yi Chiou

  9. School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan

    Hung-Yi Chiou

  10. Department of Pediatrics, Tainan Sinlau Hospital, Tainan, Taiwan

    Kuo-Sheng Tsai

  11. Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan

    Chung-Yi Li

  12. Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan

    Chung-Yi Li

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Contributions

All authors were involved in the interpretation of the data. Y.H.C., K.S.T. and C.Y.L. were conceived the study methodology and design. Y.H.C. was responsible for data collection, data management and analyses. C.Y.L., K.S.T. and Y.H.C. drafted the initial manuscript, which was reviewed and revised by all authors. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Chung-Yi Li.

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The authors declare no competing interests.

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This study was approved by the Institutional Review Board of the National Cheng Kung University Hospital (No. B-ER-109-088).

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Chang, YH., Chien, YW., Chang, CH. et al. Neurodevelopmental disorders in children born to mothers involved in maternal motor vehicle crashes. Pediatr Res (2024). https://doi.org/10.1038/s41390-024-03608-3

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  • DOI: https://doi.org/10.1038/s41390-024-03608-3

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