Induced Labor Linked to Higher Autism Risk

  • Share
  • Read Later
Getty Images/Blend Images / Getty Images/Blend Images

Artificially stimulating labor is associated with a slightly higher risk of autism, but researchers caution that the link may be complicated.

In a study published in the journal JAMA Pediatrics, women who needed to jump-start their labor or artificially speed up delivery were up to 23% more likely to have children diagnosed with autism than those who didn’t avail themselves of these methods.

The scientists stress, however, that it’s not clear whether the delivery method was responsible for the higher rate of the developmental disorder, or whether babies with autism don’t send the proper signals for a timely and speedy birth. But given the relationship, the researchers, based at Duke University and the University of Michigan, say the connection between delivery methods and autism is worth exploring, especially since the rates of both induction and augmentation are rising around the country.

(MORE: Using Movement to Diagnose and Treat Autism)

The scientists came to their conclusion after reviewing birth records for 625,000 babies in North Carolina over an eight-year period that were matched with the children’s corresponding public school records, which contained diagnoses of autism. For children who were born after induced labor, the risk of autism was 13% higher compared with that of children born to mothers who were not induced; speeding up labor was associated with a 16% higher risk of autism, while both induction and augmentation were linked to a 23% greater risk of autism in children. The researchers estimate that 2 in every 1,000 autism cases might be eliminated without labor induction or augmentation. That risk is similar to that of other autism risk factors, such as a mother’s age or being born early.

(MORE: Prenatal Exposure to Pollution Raises Risk of Autism in Kids)

“I think we’re at a point in autism research where we are really looking to uncover any possible risk factor. What this tells us is that the period around pregnancy is a very important stage in the development of a child. It seems to be a critical period for exposure to potential risk factors that might increase risk for autism. We are seeing that again in this study,” says Michael Rosanoff, associate director of Autism Speaks, who was not unaffiliated with the study. “It’s not a huge risk, but the fact that so many women may be exposed to this risk factor is what’s important and what warrants additional research into the actual mechanisms behind this association.”

The findings contribute to the growing knowledge of risk factors involved in the disorder, but the researchers recognize that induction, which is usually accomplished by giving the mom the labor hormone oxytocin, either applied directly to the cervix or in an intravenous drip, can reduce the risk of stillbirth. Speeding up labor can also lower infections in both mom and baby during delivery.

So it’s important for more studies to tease apart what is driving the association. A developing baby with autism, for example, may be affecting the pregnancy, in which case the induction is not an indicator of autism but rather a result of it. “Additional studies are needed to differentiate among potential explanations of the association, such as underlying pregnancy conditions requiring the eventual need to induce [or] augment, the events of labor and delivery associated with induction [or] augmentation, and the specific treatments and dosing used to induce [or] augment labor,” the study’s senior author Marie Lynn Miranda, dean of the University of Michigan’s School of Natural Resources and Environment, said in a statement.

(MORE: New Study Suggests Autism Can Be ‘Outgrown’)

“It’s extremely important to note that there is no causal association here. In other words, induction or augmentation of labor does not cause autism, but it may increase risk,” says Rosanoff. “For parents who are concerned, the best thing to do right now is to become educated on healthy pregnancy, typical development, and early warning signs of autism. Right now the picture isn’t clear enough from this study or what we know of risk factors for autism for doctors to change their recommendations or for parents to change their behaviors.”

12 comments
jfb238
jfb238

Both my boys were induced.  Both because of problems.  One was due to stillbirth of his sister and the other because he had tied knots in his cord and was not getting oxygen when it tightened.  Both were over a month premature.  My daughter was born right on the day she was due without any problems.  Actually, I was not even sure I was in labor it was so easy.  I arrived at the hospital and 30 minutes later she was born.  There is definitely a connection that needs to be addressed with induction.  Another down side is it is also more painful than normal labor.  My grandsons were also induced and they also have problems.  The granddaughter was not and she has always been fine.  They boys have had severe school problems.  I hope they do a study to see if there is any connection with autism and induction.  My youngest son was diagnosed with autism at 6.  He is now 17. 

NanceLeeM
NanceLeeM

My son and I fit this scenario. Did they study how many of the children had  larger than typical head circumference? I was three centimeters dilated and 100% effaced for 6 weeks. That boy would never have delivered without inducement.

US1776
US1776

Does the Autism cause the need for an Induced Birth?

Or does the Induced Birth cause the Autism?

Not clear yet.

.

TiffanyGrantom
TiffanyGrantom

The author fails to point to a growing body of evidence that medical induction and augmentation of labor through the use of pitocin and prostaglandins like Cervidil is often NOT medically indicated.  The author cites risk of infection and stillborn babies, while not explaining the circumstances in which those conditions would be a real risk.  Circumstances which are relatively rare, and which meta-studies have shown benefit more from mindful observation than from preemptive medical intervention.

Labor induction and augmentation are some of the most overused medical technologies in our country.  Doctors start talking about babies being "late" if the mother goes one or two days past her "estimated" due date of 40 weeks gestation.  And yet medical doctors and other birth professionals know that normal gestation is 38 - 42 weeks.  So why the rush to induce?

Because it makes mothers and doctors more comfortable to be in "control" of the natural processes of labor.  Labor, most often, for most women, will start and progress on its own - so long as everybody puts down the stop clock and lets it happen as our bodies are equipped to.  Refer to maternal mortality and morbidity rates in the Netherlands, where the vast majority of births are attended by midwives rather than doctors, note that the US is ranked 31 on maternal mortality and morbidity rates around the world, and ask yourself if the medical model of intervention is serving women or babies.

Links between autism and augmentation and induction are one more in a long list of woes related to medicalized birth.  And we're not getting the whole story.

AO
AO

Interesting... The homeopathic treatment Respen-A (http://www.respen-a.com/index.html) that was developed on the Pitocin / Induced Labor theory although they include the additional use of the epidural drug - a combination of the two. From their website, it looks like they are having great results but I am always the skeptic. Lack of mainstream medications opens the market for a lot of snake oil. I still find this interesting. My wife had a cesarean so I know she had the epidural but I am not sure of the Pitocin.

batgirl2013
batgirl2013

What does augmentation have to do with autism, other than that both words begin with "au"?

ews8tb
ews8tb

I'm pretty sure the author means "pitocin" as the labor-inducing hormone, not "oxytocin." Fact checking... sigh.

AnneDachel1
AnneDachel1

"A slightly higher risk'? "it's not clear"? How long will we only have guesses about autism?

Autism, once a rare disorder, is now one so common that everyone knows someone with an affected child and health officials can't tell us why. Officially, autism has no known cause or cure. There's nothing a mainstream doctor can tell a new mom whose baby was born healthy and is developing normally so that her child doesn't also end up on the autism spectrum by age two.

Every week it seems that scientists come up with another guess about autism. Almost always autism is tied to behavior of the mother. Studies link autism to older moms, moms who marry older dads, obese moms, moms who drink, moms who smoke, moms who take antidepressants while pregnant, moms who live too close to freeways, moms who don't get enough folic acid, moms who have bad antibodies, moms who have babies too close together, and now moms who had their labor induced.

Autism now affects 2 percent of our children. Among boys alone, it's one in every 31. No one has ever been able to find a comparable rate among adults, especially adults with severe autism whose symptoms are easily recognized. For all these reasons, autism should be seen as health care emergency. We need to stop treating this epidemic as a medical curiosity that we have all the time in the world to figure out.

Anne Dachel, Media editor: Age of Autism.

ltm2013
ltm2013

@ews8tb Oxytocin IS Pitocin. Pitocin is the name of the brand of synthesized oxytocin. They are one in the same, chemically-speaking

ews8tb
ews8tb

@ltm2013 @ews8tb Did not know that! Thank you. I thought oxytocin was the hormone that "bonded" you with your baby once it was born.