Associations between Prenatal Perceived Stress and Child Autism-Related Traits in the ECHO Cohort.

Publication date: Jun 01, 2026

To examine associations of prenatal perceived stress with child autism-related traits and to evaluate effect modification by both child sex and co-occurring prenatal depressive symptoms. The sample was drawn from Environmental Influences on Child Health Outcomes cohort sites with data on prenatal perceived stress (Perceived Stress Scale [PSS]) and autism-related traits (Social Responsiveness Scale, second Edition [SRS-2]). We used linear and logistic regression models to determine associations between PSS and either SRS-2 T-scores or odds of moderate-to-severe autism-related traits (SRS-2 T-score ≥65) and evaluated effect modification by sex and prenatal depressive symptoms. Among 4115 mother-child pairs, higher PSS was associated with increased severity of autism-related traits (β = 0. 15 [95% CI = 0. 13-0. 18]) and odds of moderate-to-severe traits (OR = 1. 04 [1. 04-1. 05]). There was evidence for sex-by-exposure interaction for continuous (β = 0. 18 [0. 14-0. 22]; β = 0. 13 [0. 10-0. 16], P = 0. 03) but not dichotomous trait severity (OR = 1. 05 [1. 03-1. 06]; OR = 1. 04 [1. 03-1. 05], P = 0. 52). Associations did not differ by prenatal depressive symptoms (low: n = 2,538, b = 0. 14 [0. 11-0. 18]; high: n = 889, b = 0. 10 [0. 04-0. 15]; P = 0. 66). We found small yet significant associations between prenatal stress and autism-related traits. Limited evidence for effect modification by sex or prenatal depressive symptoms suggests prenatal perceived stress influences autism-related traits after accounting for these factors.

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Semantics

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