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Induced labor may increase risk of autism in offspring

Having labor that is induced or augmented may lead to a greater chance of having a child with autism, new research reveals.

The U.S. government estimates that one in 50 school-aged kids has an autism spectrum disorder, which is the designation for a group of developmental brain disorders. All the conditions include some level of impairment when it comes to social skills, communication and behavioral issues.

Researchers looked at data from the North Carolina Detailed Birth Record and Education Research databases, which included 625,042 live births linked with school records. Of the group, 5,500 children had been diagnosed with autism.

Induced labor occurs when a medical professional intervenes in order to jump start the labor process. This usually happens when the woman is past her due date and has yet to go into labor or if there are problems with the baby or the mother's health. The doctor or midwife can use hormone medication (Pitocin) or other methods to open the mother's cervix, begin contractions and help her body prepare for vaginal birth.

According to the U.S. Census Bureau, about 23.1 percent of all births in 2008 were induced.

Doctors may also augment labor to help along the birth if the process stops or slows down for some reason. This method is less commonly used than inducing labor and often requires medication.

Overall, the researchers estimated two out of every 1,000 autism cases in boys could potentially be prevented by not inducing or augmenting labor. Though the numbers seemed small, they were statistically significant, meaning not due to random chance.

Mothers who had induced labor were 13 percent more likely to have a child with autism. Mothers with augmented labor were 16 percent more likely to have a kid with the disorder. If a mother had both methods used on her, the child was 27 percent more likely to be diagnosed with autism during childhood.

For comparison, the authors noted that a mom who had other pregnancy problems, like diabetes, increased the risk of autism in her children by 23 percent, and if the fetus was ever in distress, the chance went up 25 percent.

C-sections did not affect the rate of autism.

Other conditions during pregnancy have recently been linked to increased autism risk. An August 2012 study showed that mothers who were obese were 67 percent more likely to have children with the disorder compared to those who maintained a normal weight during pregnancy.

Taking the anti-epilepsy drug valproate has been linked to a five-fold higher risk of having a child with an autism spectrum disorder in an April 2013 study published in JAMA. Exposure to air pollution while with child was also significantly connected to higher rates of autism, a June 2013 Environmental Health Perspectives study revealed.

Though the risk in the new study may seem alarming to some, Dr. Jeffrey L. Ecker, an obstetrician at Massachusetts General Hospital, told HealthDay that mothers shouldn't be concerned if they need to have their labor assisted -- nor should they go against their doctor's recommendation.

"Women should not conclude that if they need induction or augmentation their child will have or be at high risk for autism. Nor should they seek to avoid induction (or) augmentation," Ecker, who was not involved in the study, said. "The latter reaction would ... almost certainly (increase rates of) cesarean delivery, an intervention that we know has important (negative) effects on both maternal and neonatal health."

The study published in JAMA Pediatrics on Aug. 12.

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