The rapidly rising risk of autism is a serious concern among expectant parents, especially since many new studies suggest that the factors that influence autism often happen in the womb. Now a new study suggests that artificially inducing labor is associated with a greater risk of autism, though that increased risk is small.
The study, published by the JAMA Pediatrics journal, reports that pregnant women who needed to augment or induce the labor of their child were 16 percent to 23 percent more likely to have children who were later diagnosed with autism than their counterparts. The children of women who delivered by C-section were not associated with a greater risk of autism.
Researchers of this study looked through the records of about 625,000 babies born in North Carolina during from 1990 to 1998. These birth records were then compared to the children’s public school records to identify those who had been diagnosed with autism. Of the 625,000 children in the study, about 1.3 percent of boys and 0.4 percent of girls had been diagnosed with autism, according to their school records. The boys whose moms had their labor induced were about 35 percent more likely to develop autism. The girls whose moms were given pitocin to induce labor were not more likely to develop autism, but they were slightly more likely to develop the condition if their mothers’ labors were augmented. More research needs to be done, but this study’s researchers estimate that two in every 1,000 cases of autism might be prevented if labor wasn’t induced or augmented.
The reason for this increased risk remains unclear, researchers state. The induction and augmentation process itself may play a role, but many are saying that correlation likely stems from the possibility that autistic babies in the womb do not send out the proper signals to the mother’s body to begin labor naturally. Sill others suspect that the correlation is likely due to the increased risk for autism in babies who suffered from fetal distress and other birth complications that require doctors to induce or augment the labor.
The Induced Labor Process and Risks
Inducing labor is the act of causing contractions before the labor has naturally started, and involves the use of pitocin, a synthetic drug that imitates oxytocin, the hormone released by the mother’s body to stimulate contractions. Since its manufacture in 1953, Pitocin has been widely used by hospitals on millions of births. While widely popular, the drug is not without its risks, and over the years pitocin has earned its share of critics. The World Health Organization (WHO), for example, recommends against the routine use of Pitocin and elective induction of labor, as it can cause fetal distress, increased pain and an increased risk for a ruptured uterus (though this is quite rare). Inducing labor is also associated with a greater chance of cesarean surgery. As a result, many doctors are beginning to discourage the practice of labor induction unless absolutely necessary.
It is very important for women to understand the medical reasons for inducing or augmenting labor, and while doctors acknowledge that there may be a slight to moderate risk for the development of autism (though the link is far from conclusive), they stress that labor induction can be extremely important for the health of the baby, especially if the baby is in distress or overdue. Inducing labor can also reduce the risk of stillbirth, infection and postpartum hemorrhage. It’s also worth noting that, despite the risks involved, induced and augmented labors produce healthy babies the majority of the time.
Autism Risk Factors
According to other studies, there are several other factors associated with autism as well, and looking through them can make just about every expectant parent dizzy with worry. According to some studies, factors that have been linked with a greater risk of autism include:
- Mothers aged over 35
- Fathers aged over 35
- Pregnant mothers who are obese
- Pregnant mothers with high blood pressure or diabetes
- Mothers who fall ill during pregnancy
- Boys (who are more than five times more likely to develop the condition)
- An autistic family member
- Pregnant mothers with low levels of the thyroid hormone thyroxine
- Certain medical conditions (including epilepsy, fragile X syndrome and Tourette syndrome)
- Complications during pregnancy
These risk factors are scary to consider, but experts urge parents not to over-worry; many of these risks have not yet been proven. Plenty of older mothers give birth to perfectly healthy babies, and the majority of mothers who suffer from the flu or experience any other listed conditions during pregnancy give birth to healthy babies as well.
While this study does show a loose association, study author Simon Gregory stresses that the increased risk is not “grossly significant” and that more studies need to be done to further prove the link and, more importantly, explore whether the increased risk comes from induced labor as a result of complications, or whether the increased risk comes from the act of inducing or augmenting labor itself. Both the study’s author and its critics urge pregnant women to discuss labor options with their doctors, and to keep in mind that the health risks of refusing to induce an overdue labor are much greater than the slight increased risk of autism that has not yet been solidified. Autism, Gregory notes, is “likely a cumulative effect of many genes and many environmental effects.”
No longer considered a single disease with a single cause, autism describes several conditions that show similar traits, but which have different causes. While many risk factors and possible triggers have been implicated, including induced labor, experts and study authors agree that the huge diversity of the autism spectrum means that finding any one cause of this condition is highly unlikely.