Complications at Birth, Including Hypoxic-Ischemic Encephalopathy (HIE), Tied to Autism Risk

Oxygen Deprivation at Birth, Preeclampsia, Other Factors Increased Autism Risk Up to 44%

New research in the American Journal of Perinatology conducted by Kaiser-Permanente researchers has tied complications such as birth asphyxia (oxygen deprivation at birth, formally known as hypoxic-ischemic encephalopathy, or HIE) to autism spectrum disorders (ASD), a variety of neurodevelopmental abnormalities characterized by difficulty with social interactions and communication, and several types of restricted and repetitive behaviors.

The study examined the medical records of nearly 600,000 children born in Kaiser Permanente hospitals between 1991 and 2009. Of these children, 6,225 were then diagnosed with autism spectrum disorders, more than a third of whom experienced perinatal complications. The study then differentiated the relative amount of risk that certain types of complications posed for autism risk:

  • Children exposed to complications during birth had a 10% greater chance of developing ASD than children who did not experience complications
  • Children exposed to complications before labor began had a 22% greater chance of developing ASD than children who did not experience complications
  • Children exposed to complications both before and during labor began had a 44% greater chance of developing ASD than children who did not experience complications

According to lead author Darios Getahun, MD, PhD, MPH, of the Kaiser Permanente Southern California Department of Research & Evaluation, “Our study suggests that children exposed to certain perinatal complications, especially birth asphyxia and preeclampsia, were more likely to be diagnosed with ASD than those who were not exposed, even after adjusting for factors such as gestational age at birth and a mother’s age, race and education…While there currently is no cure for ASD, early identification of children who may be at risk of developing the disorder is extremely important, as research shows that early intervention treatment services for children with ASD can greatly improve their development [emphasis added].

According to the study, the complications most highly associated with ASD is birth asphyxia (oxygen deprivation during labor and delivery) and preeclampsia (high blood pressure) in the mother. Other perinatal complications associated with autism in the studies also included:

  • Premature separation of the placenta from the uterus
  • Breech/transverse fetal presentation
  • Fetal dystocia/abnormal size or position
  • Prolapsed/exposed umbilical cord.

Early Intervention Key to Mitigating Outcomes

According to the American Speech-Language-Hearing Association, autism spectrum disorders are typically characterized by:

  • Impaired social interaction
  • Communication deficits
  • Repetitive behaviors

About 1 out of every 68 children are identified as having autism spectrum disorders with varying degrees of severity. It is key to identify ASD as early as possible, as outcomes can be improved with Early Intervention and appropriate therapeutic measures.


Reiter & Walsh - Research Links Autism to Birth Complications

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