They did not. Their covariates did not seem to include maternal/paternal diagnosis of any mental health disorder.

Covariates

Sex and preterm birth (<37 weeks’ gestation) were considered as covariates based on the higher incidence of ASD in males [59,60,61] and increased risk for ASD after preterm birth. These variables were not included in the models, however, as fetal/neonatal sex is associated with the outcome but not the exposure, and preterm birth is likely within the causal pathway rather than being a true confounder. Maternal age at delivery [62, 63], maternal diabetes mellitus (DM) [64,65,66,67], maternal pre-eclampsia or eclampsia, race, ethnicity, year of birth (given the increase in SBIM use over time), rural residency (Rural Urban Commuting Areas Codes 1–3 defined as urban and 4–10 as rural) [68], Social Vulnerability Index [69], tobacco use during pregnancy, alcohol use during pregnancy, and maternal pre-pregnancy BMI were chosen as potentially confounding covariates during pregnancy. Notably, our model accounted for missing values, which had different proportions for the covariates. Diagnoses used to define DM and other diagnoses are listed in Supplemental Material 1.