Increased Risk of Autism May Be Linked To Labor Induction and Augmentation


Summary: A study from researchers at Duke Medicine Medical Center and the University of Michigan found that autism may be associated with induced and augmented labor — but the research does not prove causation. Authors say that doctors shouldn’t change the way they manage labor and delivery based on their study, as additional research is needed.

A large, retrospective study, funded by the Environmental Protection Agency and published in JAMA Pediatrics, did not show a causal relationship between autism and labor induction or augmentation. However it did find a link, which researchers suggests warrants further study to explore potential explanations of the association (like underlying pregnancy conditions along with the events of labor and delivery) — especially since both procedures are frequently used in the delivery room. Watch this video to learn more:

Inducing labor (stimulating contractions before the onset of spontaneous labor) and augmenting labor (increasing the strength, duration or frequency of contractions during labor) have been shown to prevent complications, including stillbirth—but both interventions have been previously suggested as contributing factors to autism in smaller, inconclusive studies.

In this study, the largest of its kind, the research team reviewed birth records in North Carolina during an eight-year period, matching 625,042 births with corresponding public school records to determine which children were diagnosed with autism.

Findings showed about 1.3 percent of male children and 0.4 percent of female children received autism diagnoses. Among those children, the percentage of mothers who had induced or augmented labor was higher compared to the mothers of children who did not have autism. The estimated increase in risk took maternal and pregnancy-related risk factors (such as maternal age, socio-economic status, and pregnancy complications) into consideration.

Male infants faced a higher risk from both augmented and induced labor, with results suggesting a 35 percent higher risk of autism compared to births that didn’t require either intervention. However, only augmentation was associated with increased risk among female children. Researchers said the reason for the difference in findings between male and female children requires further investigation.

While this study provides preliminary evidence of an association between autism and labor induction/augmentation, the researchers caution that the results are preliminary.

“Additional studies are needed to differentiate among potential explanations of the association, such as underlying pregnancy conditions requiring the eventual need to induce/augment, the events of labor and delivery associated with induction/augmentation, and the specific treatments and dosing used to induce/augment labor (e.g., exogenous oxytocin and prostaglandins),” said Marie Lynn Miranda, PhD, senior author and dean of the University of Michigan School of Natural Resources and Environment.

The authors also stress that these findings be balanced with the benefits of induction and augmentation of labor.

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