Perinatal Factors Associated with Autism Spectrum Disorder in Jamaican Children.
Sepideh Saroukhani, Maureen Samms-Vaughan, MinJae Lee and 7 others
PMID 31538260WHAT IT FOUND
After adjustment, cesarean delivery, low birth weight, and preterm birth did not show a clear link with ASD in Jamaican children.
Only exploratory subgroup patterns appeared, and they need replication.
Key findings
01In unadjusted analysis, cesarean delivery was associated with ASD (matched odds ratio 1.79, 95% confidence interval 1.23-2.60), but adjusted models showed no significant association (matched odds ratios 1.18, 1.41, and 1.33).
02Low birth weight and preterm birth were not significantly associated with ASD in unadjusted analysis (matched odds ratios 1.00 and 1.54), and adjusted analyses remained non-significant (matched odds ratios 1.11 for low birth weight and 1.15, 1.01, and 1.21 for preterm birth).
03An exploratory interaction suggested parish modified the cesarean-ASD association: adjusted matched odds ratio 2.30 (95% confidence interval 1.17-4.53) for Kingston and 0.87 (95% confidence interval 0.48-1.59) for other parishes.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Perinatal details were parent-reported, so recall bias and exposure misclassification are possible. The study did not distinguish medical indications for cesarean delivery, such as complications of labor or abnormal presentation. Data on prenatal care quality, quantity, and access across parishes were not collected, so unmeasured confounding is possible. Some estimates had wide confidence intervals, and several subgroup analyses were exploratory, so they need replication. Typically developing controls were selected to match cases and may not represent a random sample of all Jamaican children.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that cesarean delivery causes ASD or that Kingston children with ASD are at higher risk because of cesarean delivery. The adjusted main association was not significant, and the Kingston result came from an exploratory interaction that the authors say needs replication.