Induction, augmentation and autism

Pregnant women whose labours are induced or augmented may have an increased risk of bearing children with autism, especially if the baby is male, according to a large, retrospective analysis by researchers at Duke Medicine and the University of Michigan.
Expediting deliveries has benefitted women with health conditions that pose a risk to them and their unborn children. Inducing and augmenting labour have been shown to prevent complications, including stillbirth. In this study, the researchers looked at records of all births in North Carolina over an eight-year period and matched 625,042 births with corresponding public school records, which indicated whether children were diagnosed with autism.

Approximately 1.3 percent of male children and 0.4 percent of female children had autism diagnoses. The percentage of mothers who had an induced or augmented labour was higher amongst children with autism than those without, in both sexes.

The findings don’t prove cause and effect, but they do suggest that among male children, labour that was both induced and augmented was associated with a 35 percent higher risk of autism, compared with labour that received neither treatment. Induced labour alone and augmented labour alone were each associated with increased risk among male children, but only augmentation was associated with increased risk among female children. The reason for this different between the sexes requires further investigation.
The authors consider the increased risk associated with induction and augmentation to be similar to other known risk factors for developing autism, like an older mother or a premature birth.

In this study, researchers noted that children later diagnosed with autism were also more likely to undergo a birth characterised by foetal distress, but they caution that more research is necessary to understand the reason for an increased risk of autism and a balance should be struck between this and induction or augmentation, which can be life saving techniques.

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