Umbilical cord blood androgen levels and ASD-related phenotypes at 12 and 36 months in an enriched risk cohort study.
Bo Y Park, Brian K Lee, Igor Burstyn and 8 others
PMID 28163867WHAT IT FOUND
In 137 high-risk infants, cord testosterone and related androgens were not associated with 12-month autism traits or 36-month social impairment scores.
A small subgroup finding in 22 infants with a female older affected sibling was imprecise.
Key findings
01In 137 infants analysed, umbilical cord testosterone, androstenedione and DHEA were not significantly associated with 12-month AOSI scores or 36-month SRS scores in either sex.
02Male infants had higher median cord testosterone than female infants, 0.61 versus 0.33 nmol/L, and higher 36-month SRS scores, geometric mean 33.4 versus 26.1, while 12-month AOSI scores were similar.
03In an exploratory subgroup of 22 infants with a female older affected sibling, higher testosterone was significantly associated with higher 12-month AOSI and 36-month SRS scores, but the authors say this is imprecise and could be chance.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study is observational, so it cannot show that prenatal androgen exposure causes ASD-related traits. Cord blood reflects late gestation and may miss the 8 to 24 week window when fetal testosterone differs most by sex. The analysed sample was modest at 137 infants, so the estimates are imprecise. 75 of 212 infants were excluded because they lacked cord blood or a principal outcome, but demographics were similar. Only 22 infants had a female older affected sibling, so the subgroup finding is imprecise and could be chance. The outcomes were continuous trait scores rather than ASD diagnoses. Residual confounding cannot be ruled out.
Declared interests
The supplied metadata lists non-U.S. Government and NIH extramural research support.
The easy way to misread this
Do not read the subgroup result as evidence that prenatal testosterone causes autism-related traits. The primary association was null, and the subgroup had only 22 infants with a female older affected sibling, so it is imprecise and may be chance.