Additive interaction between birth asphyxia and febrile seizures on autism spectrum disorder: a population-based study.
Yi Mao, Xindi Lin, Yuhan Wu and 5 others
PMID 38600595WHAT IT FOUND
Children with both birth asphyxia and febrile seizures had an autism prevalence of 7.1%, compared to 0.2% in those with neither.
This association was strongest in girls and children aged 7–10. The study identifies a risk marker, not a cause.
Key findings
01The prevalence of autism spectrum disorder was 7.1% in children with both birth asphyxia and febrile seizures, compared to 0.2% in the reference group with neither.
02In the fully adjusted model, children with both birth asphyxia and febrile seizures had an odds ratio of 21.18 for autism spectrum disorder compared to those with neither exposure.
03The additive interaction between birth asphyxia and febrile seizures was statistically significant, with an attributable proportion of 0.72 and a synergy index of 4.14.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The cross-sectional design cannot establish causality or determine the timing of events relative to ASD onset. The number of children with both exposures who had ASD was very small (n=7), making the odds ratio highly susceptible to fluctuation. Genetic factors were not assessed, so the association may reflect shared genetic risks for asphyxia, seizures, and ASD rather than a direct interaction. The study did not explore interactions with broader neurodevelopmental or physical health domains. Confidence intervals for age and sex subgroups were broad, indicating uncertainty in these specific findings.
Declared interests
The study was supported by non-U.S. government funding. No commercial conflicts of interest were reported.
The easy way to misread this
Do not interpret the high odds ratio as proof that birth asphyxia and febrile seizures cause autism. This is a cross-sectional association study with a very small number of cases in the exposed group, and it cannot rule out genetic confounding.