Chemically Induced or Augmented Labor Linked to Autism

I was surprised to read a study published in JAMA Pediatrics this week seems to link drug-induced labor with higher incidence of autism. It made me stop and scratch my head. Could that be so? Why would that be?

It's true that both those numbers are on the rise: both the incidence of labor induction and autism diagnoses. In 1990, only 9.5% of all pregnancies in the US ended in drug-induced labor. By 2006, it was up to 22%. By 2010, incidence of labor induction had climbed to over 32% nationwide and well over 40% in some areas. It's well known and documented that the increased rate of labor induction has also caused an increased Cesarean rate, but did anyone think it would be related to autism? I didn't. The numbers for autism prevalence have increased similarly in recent years: In 2002, 1 of 150 children in the US were diagnosed with the developmental disorder, and 10 years later in 2012 the incidence was 1 of 88 children according to the Center for Disease Control.

It is mathematically possible, then, that by the nature of the rapid increases in incidence of both groups there seems to be a correlation that is not really causative. However, the study shows a 13% increase in autism incidence after induced labor, and a 16% increase in incidence if drugs were used to help lab progress. It's not an enormous increase, but double digits merit further investigation.

What, then, is the link? Speculation in the medical community is that the correlation links autism to a problem in the pregnancy and not to the mechanism of the labor itself, i.e. a pregnancy that will produce a child with autism is more likely to require induction of labor. It could be that the fetus that will develop autism may not produce the biochemical signals that cause the mother to go into labor. At this point, it is all speculation. Further studies are required. But this knowledge is reason enough to question the necessity of labor induction and only opt for that intervention when it is medically necessary.

Studies in recent years have linked autism to various factors. Notable pregnancy risk factors are gestational diabetes, which causes a 23% increased risk of autism, and fetal distress which causes a 25% increase in incidence, and a new Dutch study linking low levels of the thyroid hormone thyroxine with a four-fold increase in autism incidence. The lesson here is not to induce fear, but rather to be aware that staying healthy during pregnancy and knowing the risks associated with various procedures can help to decrease several medical risks for mom and for baby.

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Comment by Marcia on August 19, 2013 at 10:28am

Interesting post. Glad to see the medical community doing some significant research on autism and looking for factors that may increase risk. As a medical editor who reads a lot about pregnancy and a mother of two who went through 2 natural deliveries, I've been concerned for a while about the increasing rates of induced labor and Cesareans. I appreciate your thoughtful research and comments at our site. Thanks for sharing the info.

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