Recurrence Risk of Autism in Siblings and Cousins: A Multinational, Population-Based Study

Stefan N. Hansen, Diana E. Schendel, Richard W. Francis, Gayle C. Windham, Michaeline Bresnahan, Stephen Z. Levine, Abraham Reichenberg, Mika Gissler, Arad Kodesh, Dan Bai, Benjamin Hon Kei Yip, H. Leonard, Sven Sandin, Joseph D. Buxbaum, Christina Hultman, A. Sourander, Emma J. Glasson, Kingsley Wong, Rikard Öberg, Erik T. Parner

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Familial recurrence risk is an important population-level measure of the combined genetic and shared familial liability of autism spectrum disorder (ASD). Objectives were to estimate ASD recurrence risk among siblings and cousins by varying degree of relatedness and by sex. Method: This is a population-based cohort study of livebirths from 1998 to 2007 in California, Denmark, Finland, Israel, Sweden and Western Australia followed through 2011 to 2015. Subjects were monitored for an ASD diagnosis in their older siblings or cousins (exposure) and for their ASD diagnosis (outcome). The relative recurrence risk was estimated for different sibling and cousin pairs, for each site separately and combined, and by sex. Results: During follow-up, 29,998 cases of ASD were observed among the 2,551,918 births used to estimate recurrence in ASD and 33,769 cases of childhood autism (CA) were observed among the 6,110,942 births used to estimate CA recurrence. Compared with the risk in unaffected families, there was an 8.4-fold increase in the risk of ASD following an older sibling with ASD and a 17.4-fold increase in the risk of CA following an older sibling with CA. A 2-fold increase in the risk for cousin recurrence was observed for the 2 disorders. There also was a significant difference in sibling ASD recurrence risk by sex. Conclusion: The present estimates of relative recurrence risks for ASD and CA will assist clinicians and families in understanding autism risk in the context of other families in their population. The observed variation by sex underlines the need to deepen the understanding of factors influencing ASD familial risk.

Original languageEnglish
Pages (from-to)866-875
Number of pages10
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume58
Issue number9
DOIs
StatePublished - Sep 2019

Bibliographical note

Funding Information:
This study was supported by grant HD073978 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Institute of Environmental Health Sciences, and the National Institute of Neurological Disorders and Stroke. The funding did not play any role in study design; collection, analysis, or interpretation of data; writing of the report; or the decision to submit the article for publication. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the California Department of Public Health.Disclosure: Dr. Schendel has received support by an unrestricted grant from the Lundbeck Foundation (iPSYCH). Dr. Sandin has received support by grants from the Beatrice and Samuel A. Seaver Foundation as a Seaver Fellow. Dr. Buxbaum has received support by a grant from the National Institute of Mental Health (MH097849). Drs. Hansen, Francis, Windham, Bresnahan, Levine, Reichenberg, Gissler, Kodesh, Yip, Leonard, Hultman, Sourander, Glasson, Wong, and Parner and Messrs. Bai and ?berg report no biomedical financial interests or potential conflicts of interest. This study was supported by grant HD073978 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Institute of Environmental Health Sciences, and the National Institute of Neurological Disorders and Stroke. The funding did not play any role in study design; collection, analysis, or interpretation of data; writing of the report; or the decision to submit the article for publication. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the California Department of Public Health. Disclosure: Dr. Schendel has received support by an unrestricted grant from the Lundbeck Foundation (iPSYCH). Dr. Sandin has received support by grants from the Beatrice and Samuel A. Seaver Foundation as a Seaver Fellow. Dr. Buxbaum has received support by a grant from the National Institute of Mental Health (MH097849). Drs. Hansen, Francis, Windham, Bresnahan, Levine, Reichenberg, Gissler, Kodesh, Yip, Leonard, Hultman, Sourander, Glasson, Wong, and Parner and Messrs. Bai and ?berg report no biomedical financial interests or potential conflicts of interest.

Publisher Copyright:
© 2019 American Academy of Child and Adolescent Psychiatry

Keywords

  • autism
  • familial risk
  • longitudinal
  • multinational
  • recurrence

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health

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