Association of Autism with Induced or Augmented Birth procedures

Rates of autism spectrum disorder continue to rise. Currently 1 in 88 children will be diagnosed as falling somewhere on the autism spectrum scale. Despite the increased interest in the causes there has been no single factor alone that seems to be the cause nor will we ever likely find a single answer. The ultimate causes will likely be a combination of factors working together and this study helps to shed some light on a factor which has not previously been studied closely.

Other research has already shown the risk of a child developing autism spectrum disorder is influenced by certain factors such as the mother’s age and educational status so this study was able to separate those risk factors and look solely at how inducing or augmenting the birth of a baby affects the risk of developing autism. Induction or augmentation both involve giving Pitocin (artificial Oxytocin, the natural hormone women’s bodies produce during childbirth) to start childbirth in induction or to speed it up after natural labor contractions have started in augmentation.

This paper reviewed the records of every baby born in the state of North Carolina from 1990-1998, a total of over 900,000 individuals. In these records they were able to identify the age of the mother, education status, race, and some of the complications that may have occurred during the birth process such as levels of fetal distress. The researchers then matched the data from the births to educational records from 1997-2007. They were able to track and match over 625,000 children to include in this study.

This study confirmed the findings of previous studies linking the known risk factors such as mothers age with increased risk of developing autism spectrum disorder but it also found that independent of those risk factors, induced or augmented birth procedures increased the chance of an autism diagnosis, especially in boys. Despite this link there are still many questions left unanswered. Is the increased chance of developing autism in an induced or augmented birth due to the exposure of the baby to Pitocin or due to other factors that put the baby in distress causing the need to induce or augment the birth process?

There is evidence to support the idea that the exposure to Pitocin affects the developing brain as children diagnosed with autism have also been found to have a change in the brain receptors for Oxytocin. Oxytocin is a hormone which has many effects during the birth process such as causing contractions and initiating milk production after giving birth. However it is a hormone with many other functions throughout life in both sexes. It is one of the hormones which strongly affects bonding and empathy between people. Traits that are typically lacking in kids diagnosed with autism.

As this paper notes several times it is not a call to arms to abandon induction or augmented birth procedures as they can be live saving for the mother and child in certain cases. What is does bring to light are new areas which need to be researched and when appropriate going with a natural birth process is best.

JAMA Pediatrics doi10.1001/jamapediatrics.2013.2904

By Dr Scott Szela

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