Malpresentation and autism spectrum disorder in the study to explore early development

Details

• Alternative Title:
  Paediatr Perinat Epidemiol
• Personal Author:
  Zhang, Yitian ; Delahanty, Michelle T. ; Engel, Stephanie M. ; Marshall, Stephen ; O’Shea, T. Michael ; Garcia, Tanya ; Schieve, Laura A. ; Bradley, Chyrise ; Daniels, Julie L.
• Description:
  Background:
  
  An infant’s presentation at delivery may be an early indicator of developmental differences. Non-vertex presentation (malpresentation) complicates delivery and often leads to caesarean section, which has been associated with neurodevelopmental delays, including autism spectrum disorder (ASD). However, malpresentation could be an early sign of an existing developmental problem that is also an upstream factor from caesarean delivery. Little research has been done to investigate the association between malpresentation and ASD.
  
  Objectives:
  
  We examine the association between malpresentation at delivery and ASD and whether this association differs by gestational age.
  
  Methods:
  
  We used data from the Study to Explore Early Development (SEED), a multisite, case–control study of children with ASD compared to population controls. The foetal presentation was determined using medical records, birth records and maternal interviews. We defined malpresentation as a non-vertex presentation at delivery, then further categorised into breech and other malpresentation. We used multivariable logistic regression to estimate the adjusted odds ratio (aOR) for the association between malpresentation and ASD.
  
  Results:
  
  We included 4047 SEED participants, 1873 children with ASD and 2174 controls. At delivery, most infants presented vertex (n = 3760, 92.9%). Malpresentation was associated with higher odds of ASD (aOR 1.31, 95% confidence interval [CI] 1.02, 1.68) after adjustment for maternal age, poverty level, hypertensive disorder and smoking. The association was similar for breech and other types of malpresentation (aOR 1.28, 95% CI 0.97, 1.70 and aOR 1.40, 95% CI 0.87, 2.26, respectively) and did not differ markedly by gestational age.
  
  Conclusions:
  
  Malpresentation at delivery was modestly associated with ASD. Early monitoring of the neurodevelopment of children born with malpresentation could identify children with ASD sooner and enhance opportunities to provide support to optimise developmental outcomes.
  
  
• Subjects:
  Adult Autism Spectrum Disorder Breech Presentation Case-Control Studies Cesarean Section Child, Preschool Delivery, Obstetric Female Gestational Age Humans Infant Infant, Newborn Labor Presentation Male Pregnancy Risk Factors

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• Keywords:
  Autism Spectrum Disorder Breech Gestational Age Malpresentation Pregnancy
• Source:
  Paediatr Perinat Epidemiol. 38(5):397-407
• Pubmed ID:
  39031568
• Pubmed Central ID:
  PMC11321235
• Document Type:
  Journal Article
• Funding:
  U10 DD000180/DD/NCBDD CDC HHSUnited States/ ; U10DD000184/CC/CDC HHSUnited States/ ; U01 DD000746/DD/NCBDD CDC HHSUnited States/ ; U10DD000182/CC/CDC HHSUnited States/ ; U10DD000498/CC/CDC HHSUnited States/ ; U10 DD000901/DD/NCBDD CDC HHSUnited States/ ; U10 DD000181/DD/NCBDD CDC HHSUnited States/ ; U01DD000748/CC/CDC HHSUnited States/ ; U01DD001216/CC/CDC HHSUnited States/ ; U01DD001210/CC/CDC HHSUnited States/ ; U01DD001215/CC/CDC HHSUnited States/ ; U01 DD000748/DD/NCBDD CDC HHSUnited States/ ; 1U01DD001209/CC/CDC HHSUnited States/ ; U01DD001205/CC/CDC HHSUnited States/ ; UR3 DD000090/DD/NCBDD CDC HHSUnited States/ ; U10DD00090/CC/CDC HHSUnited States/ ; U01 DD001216/DD/NCBDD CDC HHSUnited States/ ; U10 DD000184/DD/NCBDD CDC HHSUnited States/ ; U01DD001214/CC/CDC HHSUnited States/ ; U01 DD001210/DD/NCBDD CDC HHSUnited States/ ; U01 DD000498/DD/NCBDD CDC HHSUnited States/ ; U01DD000746/CC/CDC HHSUnited States/ ; U01DD000749/CC/CDC HHSUnited States/ ; U01 DD001205/DD/NCBDD CDC HHSUnited States/ ; U10DD000181/CC/CDC HHSUnited States/ ; U01 DD000749/DD/NCBDD CDC HHSUnited States/ ; CC999999/ImCDC/Intramural CDC HHSUnited States/ ; U01 DD000752/DD/NCBDD CDC HHSUnited States/ ; U01 DD000750/DD/NCBDD CDC HHSUnited States/ ; U10DD000180/CC/CDC HHSUnited States/ ; U01 DD001214/DD/NCBDD CDC HHSUnited States/ ; U01DD000750/CC/CDC HHSUnited States/ ; U10 DD000182/DD/NCBDD CDC HHSUnited States/ ; U01 DD001215/DD/NCBDD CDC HHSUnited States/ ; U10DD000183/CC/CDC HHSUnited States/ ; U10 DD000183/DD/NCBDD CDC HHSUnited States/ ; U01DD000752/CC/CDC HHSUnited States/
• Volume:
  38
• Issue:
  5
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:ba7ab9c96fdc26aedbcc4af292925994081f6d79031c66cae93ab542dad1c09eed9f8c6a2602e5d34fbf66d442076db574f758ba8aaaea22d7b772018f3ee530
• Download URL:
  https://stacks.cdc.gov/view/cdc/159844/cdc_159844_DS1.pdf
• File Type:
  [PDF - 931.27 KB ]