Birth complications linked to higher risk for autism

A study recently published in the American Journal of Perinatology found a link between perinatal complications and the child being diagnosed with autism spectrum disorder, and that rates of the disorder were highest among blacks, whites and boys born with birth complications.

Researchers said their findings may offer insight into which children should be monitored for autism spectrum disorder, which, according to the most recent data from the CDC, affects 1 in 68 children in the United States.

“Our study suggests that children exposed to certain perinatal complications, especially birth asphyxia and preeclampsia, were more likely to be diagnosed with [autism spectrum disorder (ASD)] than those who were not exposed, even after adjusting for factors such as gestational age at birth and a mother's age, race and education," Darios Getahun, MD, PhD, MPH, of the department of research & evaluation, Kaiser Permanente Southern California, said in a press release.

Getahun and colleagues retrospectively studied the electronic health records of 594,638 children born between 1991 and 2009, of whom 6,255 had an ASD diagnosis. They also determined exposure to antepartum and intrapartum complications.

Researchers reported that children with ASD were more likely to have been exposed to perinatal complications than children without ASD (HR = 1.15; 95% CI, 1.09-1.21). Further, the risk for ASD was greatest when both antepartum and intrapartum complications were present (HR = 1.44; 95% CI, 1.26-1.63). Children that experienced to only intrapartum complications (HR = 1.1; 95% CI, 1.04-1.17), or only antepartum complications (HR = 1.22; 95% CI, 1.1-1.36) were also at higher risk for ASD.

Besides birth asphyxia and preeclampsia, other perinatal complications associated with ASD included premature separation of the placenta from the uterus, breech/transverse fetal presentation, fetal dystocia/abnormal size or position, and a prolapsed/exposed umbilical cord, according to the researchers.

Getahun and colleagues also reported that when they used non-Hispanic whites as the reference point, the hazard ratios for ASD were 0.89 for blacks, 0.9 for Asian/Pacific Islanders, 1.01 for Hispanics, and 1.03 for all others or those born of mixed race. In addition, girls were four times less likely to be diagnosed with the disorder than boys.

“This study raises the potential for early identification of at-risk children who could benefit from further surveillance and interventions,” Getahun and colleagues wrote. “Early identification of at risk-children is critical, because early intervention with behavioral and developmental therapy in very young children with ASD can result in better long-term cognitive and behavioral function.”

Previously published research has suggested children born via assisted reproductive technology may be at greater risk for autism. – by Janel Miller

Disclosure: The researchers report no relevant financial disclosures.