Shared and disorder-specific prenatal and perinatal risk factors for neurodevelopmental disorders: a nationwide cohort study
Abstract
Neurodevelopmental disorders (NDDs) are common, frequently co-occur, and impose a substantial burden, yet the extent to which early-life risk factors differ across the spectrum of NDDs remains unclear. Using the EPI-MERES register, derived from the French National Health Data System, we conducted a nationwide cohort study of all 6.8 million children born in France between 2010 and 2018, followed until September 2024. We investigated prenatal and perinatal risk factors, including gestational age, small for gestational age (SGA), neonatal hypoxia, congenital malformations, parental age, maternal alcohol and tobacco exposure, maternal obesity, and socioeconomic disadvantage, in relation to five major NDDs: communication disorders, specific learning disorders, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and intellectual disability (ID). Models were estimated both with and without adjustment for co-occurring NDDs. Overall, 506,505 children (7.5%) were identified with at least one NDD over a median follow-up of 9.6 years. Co-occurrence was frequent, especially for ID (54.5%), ASD (52.2%), and ADHD (34.9%). In models not adjusted for NDD co-occurrence, several factors were common across disorders, including male sex, prematurity, SGA, congenital malformations, maternal obesity, prenatal alcohol and tobacco exposure, and young maternal age. In addition, some exposures showed disorder-specific associations, most notably with ID: extreme prematurity, SGA, congenital malformations, neonatal hypoxia, and advanced parental age. After adjustment for co-occurring NDDs, several associations were attenuated, indicating that some risk factors contribute simultaneously to multiple disorders; for example, the male predominance in ID and the association of extreme prematurity with ASD were substantially reduced. These findings delineate shared and disorder-specific prenatal and perinatal risk profiles and emphasize the importance of considering co-occurring diagnoses in understanding etiological pathways and informing early prevention strategies.
Related
- Cellular context defines brain-specific functions of genes associated with neurodevelopmental disorders
- SET Domain Genes in Neurodevelopmental Disorders
- Neurodevelopmental disorders in infants treated with anti-VEGF agents vs. laser photocoagulation or cryotherapy for ROP
- Parsing altered brain connectivity in neurodevelopmental disorders by integrating graph-based normative modeling and deep generative networks
- Copy number variants (CNVs) interfere with human accelerated regions (HARs) in neurodevelopmental disorders: a large-scale cohort study
BibTeX
@article{peyre2026shared,
title = {{Shared and disorder-specific prenatal and perinatal risk factors for neurodevelopmental disorders: a nationwide cohort study}},
author = {Hugo Peyre and Paula Rios and Jérémie Botton and Philippe Herlemont and Valérie Olié and Sara Miranda and Mahmoud Zureik and Alain Weill and Rosemary Dray-Spira},
journal = {Molecular Psychiatry},
year = {2026},
month = nov,
doi = {10.1038/s41380-026-03607-2},
url = {https://hal.science/hal-05851613v1},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Shared and disorder-specific prenatal and perinatal risk factors for neurodevelopmental disorders: a nationwide cohort study
AU - Hugo Peyre
AU - Paula Rios
AU - Jérémie Botton
AU - Philippe Herlemont
AU - Valérie Olié
AU - Sara Miranda
AU - Mahmoud Zureik
AU - Alain Weill
AU - Rosemary Dray-Spira
PY - 2026
DA - 2026/11/04
JO - Molecular Psychiatry
DO - 10.1038/s41380-026-03607-2
UR - https://hal.science/hal-05851613v1
AB - Neurodevelopmental disorders (NDDs) are common, frequently co-occur, and impose a substantial burden, yet the extent to which early-life risk factors differ across the spectrum of NDDs remains unclear. Using the EPI-MERES register, derived from the French National Health Data System, we conducted a nationwide cohort study of all 6.8 million children born in France between 2010 and 2018, followed until September 2024. We investigated prenatal and perinatal risk factors, including gestational age, small for gestational age (SGA), neonatal hypoxia, congenital malformations, parental age, maternal alcohol and tobacco exposure, maternal obesity, and socioeconomic disadvantage, in relation to five major NDDs: communication disorders, specific learning disorders, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and intellectual disability (ID). Models were estimated both with and without adjustment for co-occurring NDDs. Overall, 506,505 children (7.5%) were identified with at least one NDD over a median follow-up of 9.6 years. Co-occurrence was frequent, especially for ID (54.5%), ASD (52.2%), and ADHD (34.9%). In models not adjusted for NDD co-occurrence, several factors were common across disorders, including male sex, prematurity, SGA, congenital malformations, maternal obesity, prenatal alcohol and tobacco exposure, and young maternal age. In addition, some exposures showed disorder-specific associations, most notably with ID: extreme prematurity, SGA, congenital malformations, neonatal hypoxia, and advanced parental age. After adjustment for co-occurring NDDs, several associations were attenuated, indicating that some risk factors contribute simultaneously to multiple disorders; for example, the male predominance in ID and the association of extreme prematurity with ASD were substantially reduced. These findings delineate shared and disorder-specific prenatal and perinatal risk profiles and emphasize the importance of considering co-occurring diagnoses in understanding etiological pathways and informing early prevention strategies.
SN - 1359-4184
SN - 1476-5578
ER -