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Autism Linked to Induced Labor

Monday, September 2nd, 2013

Researchers are constantly trying to find things that might be causing or linked to autism, and inducing labor (intentionally stimulating contractions before labor begins spontaneously) and augmenting labor (making contractions stronger, longer, or more frequent) are the latest suspects. Recent studies show that induction and augmentation of labor seem to be linked to the development of autism in children.

In epidemiological studies of over 600,000 live births, including 5,500 children with autism, researchers studied whether the births were induced, augmented, or both, and whether there was a correlation between that and whether the children had autism.

Children born without induction or augmentation were indeed less likely to develop autism than children whose mothers’ labors were induced, augmented, or both. The studies controlled for factors like socioeconomic status, the health of the mother, and the year of birth. Male children were found to be particularly susceptible to an increased risk of autism when their births involved induction or augmentation.

Further studies are needed, of course, to examine additional potential influences such as underlying conditions, other labor events, and the specific dosing used in induction. And women should not think that this makes Pitocin (the drug commonly used to stimulate contractions) the enemy or be afraid to use it if the situation so warrants. Pitocin (oxytocin) saves lives and prevents days-long labors that can cause serious harm to mother and baby. The increased risk of developing autism is slight, so mothers should realize that, should their doctors deem it necessary, Pitocin is still a safe choice.

Pitocin Not the Only Suspect

Keep in mind, too, that autism most likely has more than one cause. Other studies have shown other possible correlations, such as low levels of certain hormones, certain infectious agents, and some chemicals. Additionally, many parents have been concerned in recent years about a link between vaccines and autism – but studies show that no such link exists (see here and here).  This study, however, did not control for the type of anesthesia or the length of anesthesia.  My theory (for the past twenty years) has been that the prolonged infusion of epidural anesthesia for many hours during the induced or augmented labors (“Where’s my Epidural?”) is the culprit.  Not oxytocin.  Epidural anesthesia DOES cross the placenta.  Therefore, if the anesthetic can interfere with the neural transmission of pain in the mother, then surely it can interfere with the central nervous system (brain) of the fetus, neonate and infant.  The brain continues to develop until five years of age and if there had been an insult during the course of labor, it most likely will be manifested in the form of autism during childhood.  I say this, because my midwifery colleagues whose patients rarely use epidural and the lower socioeconomic moms, who either come in too late for an epidural or do not request it, rarely have children with autism.   However, I also predict that the incidence of autism will decrease in the years to come, secondary to the “new” maternal culture which demands elective cesarean deliveries and therefore, never experiences the many, many hours of labor; or having a gestational host (surrogate), who takes all the risks of pregnancy and labor only to have the biological parents come by and pick of their newborn, like a pizza.

The bottom line is that parents should not endanger their health or the health of their children by refusing treatments that are known to be reasonably safe, like Pitocin (oxytocin) and vaccines. More studies are needed and researchers are constantly trying to fill in the gaps in what we know, but for now, the benefits of Pitocin (and vaccines) are known to far outweigh any potential risks. Talk to your doctor about your concerns and to stay informed of the latest research so that you can make the best possible decisions for your family.

– Yvonne S. Thornton, M. D., M. P. H.