A quarterly publication of the Autism Research Institute

The Autism Research Review International is quarterly publication of the Autism Research Institute

Spring, 2023 | Number 2, Volume 37

Research suggests an association between ASD, maternal lithium exposure

Mothers exposed during pregnancy to elevated levels of lithium in drinking water may have an increased likelihood of having a child with an autism spectrum disorder (ASD), according to a new study from researchers in Denmark, the United Kingdom, and the United States. 

Zeyan Liew and colleagues analyzed data on 8,842 children diagnosed with ASD and 43,864 controls matched by age and sex from the Danish Medical Birth Registry. The researchers calculated mothers’ lithium exposure by linking maternal addresses to measurements of lithium levels in 151 waterworks across Denmark, controlling for multiple factors including maternal characteristics, socioeconomic factors, and air pollution exposures. 

They report that as lithium levels increased, so did the odds of an autism diagnosis. Compared to lithium levels in the lowest 25th percentile, lithium levels in the second and third quartiles were associated with a 24 to 26 percent higher likelihood of autism. In the highest quartile, the likelihood was 46 percent higher compared to the lowest quartile. 

The researchers conclude, “This study suggests that naturally occurring lithium in drinking water may be a novel environmental risk factor for ASD development that requires further scrutiny.” They note that while theirs appears to be the first study to explore the possible association between maternal lithium exposure and ASD, prior findings from Denmark have indicated that exposure to continual, low-dose lithium from drinking water may play a role in the occurrence of adult-onset neuropsychiatric disorders. 

They also note, “In the future, anthropogenic sources of lithium in water may become more widespread because of lithium battery use and disposal in landfills with the potential for groundwater contamination.”


“Association between estimated geocoded residential maternal exposure to lithium in drinking water and risk for autism spectrum disorder in offspring in Denmark,” Zeyan Liew, Qi Meng, Qi Yan, Jörg Schullehner, Birgitte Hansen, Søren Munch Kristiansen, Denitza D. Voutchkova, Jørn Olsen, Annette Kjær Ersbøll, Matthias Ketzel Ole Raaschou-Nielsen, and Beate R. Ritz, JAMA Pediatrics, April 3, 2023 (online). Address: Zeyan Liew, Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut, [email protected]


“Higher lithium levels in drinking water may raise autism risk,” Medical Xpress, April 3, 2023.