Regional differences in autism and intellectual disability risk associated with cesarean section delivery

Details

• Alternative Title:
  Autism Res
• Personal Author:
  Bilder, Deborah A. ; Sullivan, Scott ; Hughes, Michelle M. ; Dalton, Susan ; Hall-Lande, Jennifer ; Nicholls, Connor ; Bakian, Amanda V.
• Description:
  Prior epidemiological studies investigating the association between delivery mode (i.e., vaginal birth and cesarean section [C-section]) and autism spectrum disorder (ASD) and intellectual disability (ID) risk have reported mixed findings. This study examined ASD and ID risks associated with primary and repeat C-section within diverse US regions. During even years 2000-2016, 8-years-olds were identified with ASD and/or ID and matched to birth records [ASD only (N = 8566, 83.6% male), ASD + ID (N = 3445, 79.5% male), ID only (N = 6158, 60.8% male)] using the Centers for Disease Control and Prevention's Autism and Developmental Disabilities Monitoring Network methodology. The comparison birth cohort (N = 1,456,914, 51.1% male) comprised all births recorded in the National Center for Health Statistics corresponding to birth years and counties in which surveillance occurred. C-section rates in the birth cohort demonstrated significant regional variation with lowest rates in the West. Overall models demonstrate increased odds of disability associated with primary and repeat C-section. Adjusted models, stratified by region, identified significant variability in disability likelihood associated with repeat C-section: increased odds occurred for all case groups in the Southeast, for ASD only and ID only in the Mid-Atlantic, and no case groups in the West. Regional variability in disability risk associated with repeat C-section coincides with differences in birth cohorts' C-section rates. This suggests increased likelihood of disability is not incurred by the procedure itself, but rather C-section serves as a proxy for exposures with regional variability that influence fetal development and C-section rates.
• Subjects:
  Autism Spectrum Disorder Birth Cohort Cesarean Section Child Female Humans Intellectual Disability Male Pregnancy Risk Factors United States

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• Keywords:
  Autism Cesarean Section Epidemiology Intellectual Disability Prenatal Risk Factors
• Source:
  Autism Res. 17(11):2418-2429
• Pubmed ID:
  39420702
• Pubmed Central ID:
  PMC11568895
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/ ; CC/CDC HHSUnited States/
• Volume:
  17
• Issue:
  11
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:f919ef649a41ab01fe8ba2e725dcc14c6bdd925d619e1aff84f52716deaf1b9d345af6722e7dbef4737bf59dc5e1e3f13f4cd2e74c4fcc07ee71744f74ef6af7
• Download URL:
  https://stacks.cdc.gov/view/cdc/170003/cdc_170003_DS1.pdf
• File Type:
  [PDF - 1.01 MB ]