Use of beta2-adrenergic receptor agonist during pregnancy linked to ASD

Use of beta2-adrenergic receptor agonist, a drug used to treat asthma and used off-label to prevent premature birth, before and during pregnancy, increased the risk for autism spectrum disorder, according to recent research in Pediatrics.

“We conducted a population-based case-control study to estimate the associations of maternal exposure to [beta2-adrenergic receptor (B2AR)] agonist drugs used during preconception and pregnancy with the risk of delivering a child who goes on to develop [autism spectrum disorder (ASD)],” Nicole B. Gidaya, PhD, of the School of Public Health at Drexel University, and colleagues wrote. “B2AR agonist drug exposure during pregnancy may be associated with an increased risk for ASD.”

The researchers extracted data from Denmark’s health and population registers for children born between 1997 and 2006. They matched and compared 5,200 cases of children diagnosed with ASD to 52,000 cases of children without ASD by month and birth year. The researchers examined the effects of using B2ARs during preconception, pregnancy and for each trimester.

Study results showed that 3.7% of children from the ASD cohort were exposed to B2ARs, while 2.9% of children from the control cohort were exposed to B2ARs. The researchers determined that B2AR exposure during pregnancy was associated with an increased risk for ASD, independent of maternal asthma and other factors (OR = 1.3; 95% CI, 1.1-1.5). Further, the increased risk posed by B2AR exposure was demonstrated as a result of use before conception (adjusted OR = 1.3; 95% CI, 1-1.6), as well as during the first trimester (aOR = 1.1; 95% CI, 0.9-1.4), second trimester (aOR = 1.5; 95% CI, 1.1-1.7) and third trimester (aOR = 1.4; 95% CI, 1.1-1.7).

The researchers said longer use of B2ARs during pregnancy was somewhat associated with an increased risk for ASD.

Gidaya and colleagues cautioned that these finding must be considered in context with their public health implications.

“Under the assumptions that the association we observed is causal and precisely calculated, we estimate that less than 1% of ASD cases in the population can be attributed to prenatal B2AR agonists drug exposure,” they wrote. “Given this, with respect to individual decisions regarding B2AR agonist drug use during pregnancy, because uncontrolled asthma in pregnancy has been associated with poor birth outcomes, any potential modestly increased ASD risk needs to be carefully balanced against the established benefits of indicated medication use.” – by David Costill

Disclosure: The researchers report no relevant financial disclosures.