title: Association of Perinatal Risk Factors with Autism Spectrum Disorder.
abstract: ObjectiveTo examine the association between exposures to perinatal factors and autism spectrum disorders (ASD).Study DesignA retrospective cohort study of ASD among children born in Kaiser Permanente Southern California hospitals between 1991 and 2009 (n= 594,638). Medical records were used to determine exposure to perinatal (antepartum and intrapartum) complications. ASD was diagnosed using DSM-IV criteria. Multivariable Cox regression was used to estimate hazard ratios (HRs).ResultChildren with ASD were more likely to be exposed to perinatal complications (HR = 1.15, 95% confidence interval [CI]: 1.09-1.21) than neurotypical children. Children exposed to antepartum (HR = 1.22, 95% CI: 1.10-1.36) and intrapartum (HR = 1.10, 95% CI: 1.04-1.17) complications were at increased risk of ASD. The risk was even greater when both antepartum and intrapartum conditions were present (HR = 1.44, 95% CI: 1.26-1.63).ConclusionExposure to antepartum or intrapartum complications increases the risk of ASD in the offspring. Therefore, pregnancy complications may help identify children who could benefit from early screening and intervention for this common neurodevelopmental condition.
authors.affiliation: Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California.
authors.forename: Darios
authors.initials: D
authors.lastname: Getahun
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics-Gynecology, Kaiser Permanente Southern California, West Los Angeles, Los Angeles.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Fassett
authors.affiliation: Winthrop University Hospital Research Institute, Winthrop University Hospital, Mineola, New York.
authors.forename: Morgan R
authors.initials: MR
authors.lastname: Peltier
authors.affiliation: Department of Obstetrics-Gynecology, University of California, Irvine, California.
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Wing
authors.affiliation: Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California.
authors.forename: Anny H
authors.initials: AH
authors.lastname: Xiang
authors.affiliation: Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California.
authors.forename: Vicki
authors.initials: V
authors.lastname: Chiu
authors.affiliation: Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Jacobsen
mesh_terms: D000293:Adolescent; D000328:Adult; D001034:Apgar Score; D001237:Asphyxia / Q000453:epidemiology*; D000067877:Autism Spectrum Disorder / Q000453:epidemiology*; D002140:California / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D007744:Obstetric Labor Complications / Q000453:epidemiology*; D011225:Pre-Eclampsia / Q000453:epidemiology*; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology*; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult