This pooled prospective cohort study (ECHO, 20 sites, n=3,339 mother-child pairs, recruited 1997–2019) examined whether prenatal organophosphate (OP) pesticide exposure — measured via urinary TCPy and ΣDAP metabolites — was associated with autism-related traits in children ages 2–19, using the Social Responsiveness Scale (SRS).
After full covariate adjustment, prenatal OP exposure showed no significant association with autism-related traits: β per doubling of TCPy = -0.13 (95% CI, -0.57 to 0.31) and β per doubling of ΣDAP = -0.42 (95% CI, -1.03 to 0.19). Apparent inverse associations in crude models disappeared with full adjustment.
- Urinary OP metabolites reflect short-term exposure and may not capture the full prenatal window. - Dietary quality was self-reported and may not fully account for confounding by healthy dietary patterns. - Generalizability is uncertain; higher agricultural or occupational exposures were not well represented.
Prenatal OP exposure at population-typical dietary levels does not appear to increase autism-related traits in children. Clinicians can note that prior crude associations were likely confounded, though broader OP reduction efforts remain warranted given other neurotoxicity evidence.
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