Labor induction or augmentation 'does not cause autism,' say obstetricians
Past research has suggested that induction or augmentation during labor may cause autism spectrum disorder in newborns. But a new statement from the American College of Obstetricians and Gynecologists says there is insufficient evidence to support this theory.
Last year, Medical News Today reported on a study from Duke University Medical Center in Durham, NC, indicating that mothers who had an induction to encourage uterine contractions during labor or augmentation - a process that increases the strength, frequency or duration of contractions - may be more likely to have children diagnosed with autism.
Other studies have revealed similar findings, blaming exposure to oxytocin - a hormone administered in the majority of induced or augmented labors - for the link between labor induction or augmentation and autism.
But the new Committee Opinion, released by the American College of Obstetricians and Gynecologists (ACOG), states that evidence for such an association is "inconsistent and does not demonstrate causation."
Research to date 'has many limitations'
To reach their findings, to be published in the journal Obstetrics & Gynecology, the ACOG Committee on Obstetric Practice reviewed a series of studies that analyzed the link between oxytocin and autism in children.
The Committee found that such research to date has a number of limitations. For example, they say many studies are small in size, are made up of retrospective data and fail to accurately consider other influential factors.
The ACOG Committee says there is insufficient evidence to suggest that labor induction or augmentation causes autism and that such studies should not influence patient care.
"Such characteristics reduce the value of these studies and suggest the need for more research," the Committee says.
Explaining their findings in detail, the Committee points to a 2012 summary of nine studies looking at the link between labor induction and autism. Of these, three studies found a weak but significant link, while six studies found no association at all. Only one study found a persistent association after taking other influential factors into account.
Speaking of the 2013 Duke University Medical Center study, the Committee says the design of this study was not able to determine whether the link between labor induction or augmentation and autism is a result of cause and effect.
Based on their findings, the Committee says:
"Current evidence does not identify a causal relationship between labor induction or augmentation in general, or oxytocin labor induction specifically, and autism or ASD."
Studies 'should not influence patient practice'
Dr. Jeffrey L. Ecker, chair of the Committee on Obstetric Practice, says that labor induction and augmentation play an "essential role" in protecting the health of some mothers and ensuring that many babies are delivered safely.
Because of the lack of evidence supporting an association between labor induction and augmentation and autism, he says current studies suggesting such a link should not influence how obstetricians care for pregnant women and their infants.
The Committee conclude:
"Recognizing the limitations of available study design, conflicting data, and the potential consequences of limiting labor induction and augmentation, the Committee on Obstetric Practice recommends against a change in current guidance regarding counseling and indications for and methods of labor induction and augmentation."
A recent study reported by Medical News Today suggests that taking certain medications to treat depression, anxiety and other mental health problems during pregnancy may increase the risk of developmental delays and autism for male children.
Written by Honor Whiteman
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