An analysis of North Carolina birth and educational records suggests that induction and augmentation during childbirth appear to be associated with increased odds of autism diagnosis in childhood.
Induction was defined in the study, published Aug. 12 on the website of JAMA Pediatrics, as stimulating uterine contractions before the onset of spontaneous labor. Augmentation was defined as increasing the strength, duration or frequency of uterine contractions with spontaneous onset of labor.
Simon G. Gregory, PhD, of Duke University Medical Center in Durham, N.C., and colleagues performed an epidemiological analysis of 625,042 live births linked with school records, including 5,500 children with a documented exceptionality designation for autism, using the North Carolina Detailed Birth Record and Education Research databases.
Compared with children born to mothers who received neither labor induction nor augmentation, children born to mothers whose labor was induced and augmented had a 27% higher risk of autism. Those whose mothers were induced only had a 10% higher risk, and those whose mothers had augmented labor only had a 15% higher risk. The researchers controlled for potential confounders related to socioeconomic status, maternal health, pregnancy-related events and conditions and birth year.
The observed associations between labor induction/augmentation and autism were particularly pronounced in male children, the researchers reported.
“While these results are interesting, further investigation is needed to differentiate among potential explanations of the association including 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),” the authors concluded.
Study abstract: http://archpedi.jamanetwork.com/article.aspx?articleid=1725449.