The Complex Etiology of Autism Presents Challenges in Risk Communication.

Abstract

* Abbreviations: ASD — : autism spectrum disorder B2AR — : β-2 adrenergic receptor Research has revealed a complicated genetic architecture and a variety of environmental factors that increase risk for autism spectrum disorder (ASD).1 In fact, the more we learn about potential risk factors associated with ASD, the more complex the search for causal mechanisms becomes. Epidemiologic studies, like that by Gidaya et al2 published in this issue of Pediatrics , provide important information on modifiable exposures that increase the risk of ASD. The study by Gidaya et al found that exposure during pregnancy to a class of drugs used for treating asthma or allergies, β-2 adrenergic receptor (B2AR) agonists, is associated with a modest increase in risk for ASD. Asthma or allergies during the second trimester is also associated with higher risk for ASD. Gidaya et al’s study, however, included maternal asthma as a covariate, and the association between exposure to B2AR agonists during pregnancy and increased ASD risk remained. Given that uncontrolled maternal asthma can potentially negatively … Address correspondence to Geraldine Dawson, PhD, Duke Center for Autism and Brain Development, 2608 Erwin Rd, Duke University, Durham, NC 27705. E-mail: geraldine.dawson{at}duke.edu