Health characteristics of reproductive-aged autistic women in Ontario: A population-based, cross-sectional study.
Ami Tint, Hilary K Brown, Simon Chen and 6 others
PMID 33467914WHAT IT FOUND
Autistic reproductive-aged women had higher rates of chronic disease, mental illness, assault, and pregnancy-risk medications, plus more material deprivation after age adjustment.
They also had better primary care continuity.
Key findings
01Autistic women had higher rates of diabetes (4.3% vs 2.3%) and asthma (26.2% vs 17.5%), and after age standardization also higher hypertension (5.3% vs 2.8%) and chronic conditions, both stable (27.3% vs 19.2%) and unstable (18.3% vs 12.6%).
02Autistic women had higher rates of psychiatric conditions, including psychotic mental illness (9.1% vs 1.1%), mood and anxiety disorders (31.8% vs 13.4%), substance use disorders (2.4% vs 1.1%), self-harm (3.9% vs 0.4%), and other mental illness (3.7% vs 0.4%).
03Autistic women had higher use of potentially teratogenic medication (28.8% vs 11.2%) and higher recorded assault history (5.8% vs 2.8%), but also higher high continuity of primary care (35.3% vs 28.1%).
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study used administrative records, so some women may have been identified as autistic when they were not, and some autistic women may have been missed if they had no coded encounter. Autism may be underdiagnosed in girls and women, which could bias comparisons toward the null. The autistic group was younger than the comparison group; analyses were age-standardized but not based on an age-matched comparison. The design was cross-sectional, so it cannot show that autism caused the health differences. Only one billing code was allowed per outpatient visit, and other factors such as co-occurring disabilities, smoking, body mass index, epilepsy, gastrointestinal symptoms, and sleep difficulties were not measured. The medication comparison was limited to women eligible for Ontario's public drug benefits: 49.1% of autistic women and 11.4% of non-autistic women. Social determinants were measured only at neighbourhood level, and race and ethnicity were not available in Ontario health records.
Declared interests
No author conflict-of-interest declaration is included in the supplied text. Publication types list NIH extramural and non-U.S. government research support.
The easy way to misread this
Do not read the higher rates as proof that autism causes poorer health or that any therapy works. The study is cross-sectional, autism was identified from administrative diagnoses, and many possible explanations were not measured, including co-occurring disabilities, smoking, body mass index, epilepsy, gastrointestinal symptoms, and sleep difficulties.