Prenatal Ultrasound Use and Risk of Autism Spectrum Disorder: Findings from the Case-Control Study to Explore Early Development

Details

• Personal Author:
  Alexander AA ; Callaghan WM ; Christensen D ; Croen LA ; Dowling NF ; England LJ ; Overwyk KJ ; Pazol K ; Schieve LA ; Shapira SK ; Tian LH ; Tinker SC ; Windham GC
• Description:
  Background: Studies evaluating the association between prenatal ultrasounds and autism spectrum disorder (ASD) have largely produced negative results. Concern remains due to the rising identification of children with ASD and ultrasound use. Objective: To evaluate the association between prenatal ultrasound use and ASD. Methods: We used data from the Study to Explore Early Development, a multisite case-control study of preschool-aged children with ASD implemented during 2007-2012. We recruited cases from children receiving developmental disability services and randomly selected population controls from birth records. ASD case status was based on in-person standardised assessments. We stratified analyses by pre-existing maternal medical conditions and pregnancy complications associated with increased ultrasound use (ultrasound indications) and used logistic regression to model case status by increasing ultrasound counts. For pregnancies with medical record data on ultrasound timing, we conducted supplementary tests to model associations by trimester of exposure. Results: Among 1524 singleton pregnancies, ultrasound indications were more common for ASD cases than controls; respectively, for each group, no indications were reported for 45.1% and 54.2% of pregnancies, while ≥2 indications were reported for 26.1% and 18.4% of pregnancies. The percentage of pregnancies with multiple ultrasounds varied by case status and the presence of ultrasound indications. However, stratified regression models showed no association between increasing ultrasound counts and case status, either for pregnancies without (aOR 1.01, 95% CI 0.92, 1.11) or with ultrasound indications (aOR 1.01, 95% CI 0.95, 1.08). Trimester-specific analyses using medical record data showed no association in any individual trimester. Conclusions: We found no evidence that prenatal ultrasound use increases ASD risk. Study strengths included gold-standard assessments for ASD case classification, comparison of cases with controls, and a stratified sample to account for conditions associated both with increased prenatal ultrasound use and ASD. [Description provided by NIOSH]
• Subjects:
  Epidemiology Occupational Health Pregnancy Safety
• Keywords:
  ASDs Author Keywords: Autism Autism Spectrum Disorders Case Control Studies Children Developmental Disorder Developmental Disorders Pregnancy Complications Prenatal Exposure Prenatal Ultrasound Ultrasound

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• ISSN:
  0269-5022
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  California ; Georgia ; OSHA Region 3 ; OSHA Region 4 ; OSHA Region 9 ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  37
• Issue:
  6
• NIOSHTIC Number:
  nn:20068099
• Citation:
  Paediatr Perinat Epidemiol 2023 Aug; 37(6):527-535
• Contact Point Address:
  Karen Pazol, Child Development and Disabilities Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
• Email:
  kpazol@cdc.gov
• Federal Fiscal Year:
  2023
• Peer Reviewed:
  True
• Source Full Name:
  Paediatric and Perinatal Epidemiology
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:f1846b982d0185544fae06b35b3256fa6f19b035ac83428ae4f2b39ad772958dae18055a19f4e9b8282a9a9a8f27b8e2e0dbe0a8f71b1ba716fefbd6b79df117
• Download URL:
  https://stacks.cdc.gov/view/cdc/230316/cdc_230316_DS1.pdf
• File Type:
  [PDF - 608.75 KB ]