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Autism risk not associated with labor induction in sibling comparison
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No link was detected between the risk for autism spectrum disorders in siblings who were induced and not induced during labor, according to study findings in Sweden.
“Causal speculation has largely focused on the potential role of oxytocin, which is administered to stimulate uterine contractions,” Anna Sara Oberg, PhD, fellow in the department of epidemiology at Harvard T.H. Chan School of Public Health, and colleagues wrote. “Oxytocin is a neurotransmitter involved in social function and cognition, and it has been hypothesized that predelivery exposure could predispose to [autism spectrum disorder (ASD)] due to a downregulation of oxytocin receptors.
“Alternatively, it may not be the method but the intervention per se that increases risk of offspring ASD, by setting off downstream complications with a negative influence on neurodevelopment.”
To determine a correlation between labor induction and the risk for ASD, the researchers pooled a cohort from the Medical Birth Register of all live births in Sweden from 1992 to 2005. The researchers used HR to quantify links between labor induction and offspring ASD, and in addition compared exposure-discordant births to the same woman as a control measure for unknown environmental and genetic markers shared by siblings.
The cohort included 1,362,950 births and 22,077 children (1.6%) were diagnosed with ASD at ages 8 through 21 years. A statistically significant association was observed between labor inductions and ASD diagnosis (adjusted HR = 1.19; 95% CI, 1.13-1.24) after factoring in potential confounders. No link existed, however, in siblings who were not induced vs. those who were, indicating no association between induced labor and offspring ASD (HR = 0.99, 95% CI, 0.88-1.1).
“Consistent with recent prior studies, we observed a significant crude association between induction of labor and the risk of ASD that persisted also after adjustment measured maternal factors and pregnancy conditions that were prespecified as potential confounders,” the researchers wrote. “However, when we applied a fixed-effects model to compare induction-discordant siblings to each other, this association was no longer present.” – by Kate Sherrer
Disclosure: The researchers report no relevant financial disclosures.
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