Research Article| January 01 2014 Is Autism Associated With Induced or Augmented Labor? AAP Grand Rounds (2014) 31 (1): 4. https://doi.org/10.1542/gr.31-1-4 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Is Autism Associated With Induced or Augmented Labor?. AAP Grand Rounds January 2014; 31 (1): 4. https://doi.org/10.1542/gr.31-1-4 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: autistic disorder, labor, labor induction Source: Gregory SG, Anthopolos R, Osgood CD, et al. Association of autism with induced or augmented childbirth in North Carolina Birth Record (1990–1998) and Education Research (1997–2007) databases. JAMA Pediatr. 2013; 167(10): 959– 966; doi: https://doi.org/10.1001/jamapediatrics.2013.2904Google Scholar Investigators at the University of Michigan and Duke undertook a population-based study to look for an independent association between autism spectrum disorder (ASD) and a history of induced and/or augmented labor. For the study, the investigators linked North Carolina birth records from 1990 to 1998 with state education data for the 1997–1998 through 2007–2008 academic years. Birth data were abstracted from the North Carolina Detailed Birth Record, which details all live births in the state, including parental demographics and labor and delivery complications. Education data, including the federally designated exceptionality diagnosis of ASD, were abstracted from records maintained by the North Carolina Education Research Data Center (NCERDC), which documents all students enrolled in North Carolina public schools. The study population was restricted to non-Hispanic white or black children born to mothers aged 15 to 49 years. Children were classified as having an ASD if there was a clinical diagnosis of autism coupled with a school psychologist’s evaluation utilizing standard individualized testing. Labor was separated into 4 groups: (1) neither augmentation nor induction (reference), (2) both augmentation and induction, (3) augmentation only, and (4) induction only. Multivariable logistic regression was used to control for potentially confounding variables; odds ratios (OR) and a covariate-adjusted population attributable risk (PAR) were calculated for the association between ASD and labor induction/augmentation. Of the 910,887 births recorded during the study period, 678,078 (74.4%) were matched to NCERDC records. Further exclusions resulted in a total study population of 625,042. A total of 5,648 (0.9%) children had the diagnosis of ASD; 76% of these were male. Children with an ASD were more likely to have experienced fetal distress. After adjusting for important potential confounding variables, boys born to mothers who received both induction and augmentation had 35% higher odds of developing autism than the reference group (OR = 1.35; 95% CI, 1.10–1.66). ORs for boys in the induced-only and augmented- only groups were 1.18 (95% CI, 1.08–1.3) and 1.15 (95% CI, 1.05–1.25), respectively. In girls, the only labor category associated with a significant increase in risk of ASD was the augmented-only group (OR = 1.18; 95% CI, 1.02–1.36). The calculated PAR of 0.002 (95% CI, 0.001–0.003) indicates that for every 1,000 mothers carrying boys who would be induced and augmented, 2 cases of autism would be prevented by avoiding both. The authors conclude that because the benefits of post-dates labor induction and augmentation cannot be overlooked, and a causal relationship between these interventions and ASD may not exist, more research is needed into this association before a change in practice can be recommended. Dr Springer has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial... You do not currently have access to this content.
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