Objective <p>Elevated maternal testosterone (T) during pregnancy disrupts neurodevelopment and behavior in offspring, mimicking features of autism spectrum disorder (ASD).</p> Methods <p>In a rat study, dams received daily T injections (0.5 mg/kg) from gestational days 12–20, doubling maternal plasma T to mimic levels seen in pregnancy complications. Controls received vehicle. Offspring were assessed neonatally (postnatal day 9) for communication (ultrasonic vocalizations), neurogenesis (NeuN+ neurons), myelination (MBP+ area), and brain docosahexaenoic acid (DHA). Adolescent offspring (6–8 weeks) underwent behavioral tests for cognition (Y-maze, novel object recognition) and sociability (three-chamber test).</p> Results <p>T-exposed pups had lower birth weights and reduced vocalizations during maternal separation. Sex-specific neural changes observed: males showed reduced cortical neuron density, while females had diminished corpus callosum myelination. Both sexes exhibited decreased brain DHA. In adolescence, T offspring displayed cognitive deficits (impaired spatial/recognition memory) and social impairments (reduced sociability and social novelty preference).</p> Conclusion <p>The study highlights maternal T as a risk factor for neurodevelopmental disorders, with sex-specific effects on brain structure and function. Reduced brain DHA suggests a mechanistic link, implicating lipid metabolism in T-associated neurodevelopmental disruptions. These findings support further exploration of DHA supplementation as a therapeutic strategy to mitigate adverse outcomes in high-risk pregnancies.</p> Impact <p><UnorderedList Mark="Bullet"> <ItemContent> <p>Elevated maternal testosterone (T) during pregnancy induces ASD-like neurobehavioral deficits (e.g., impaired communication, social/cognitive dysfunction) and sex-specific neural alterations in offspring.</p> </ItemContent> <ItemContent> <p>Prenatal T differentially impacts male vs. female brain structure: T-exposed males show cortical neuron loss, while females exhibit myelination deficits in the corpus callosum.</p> </ItemContent> <ItemContent> <p>First to connect maternal T-driven offspring brain docosahexaenoic acid (DHA) reduction to neurodevelopmental impairment.</p> </ItemContent> <ItemContent> <p>Supports prenatal DHA supplementation as a strategy to mitigate neurodevelopmental risks in high-T pregnancies.</p> </ItemContent> <ItemContent> <p>Informs policies addressing rising neurodevelopmental disorder rates linked to maternal metabolic/endocrine imbalances.</p> </ItemContent> </UnorderedList></p> <p></p>