Numerous Confounders Affecting the Alleged Association Between Cesarean Deliveries Under General Anesthesia and Autism Spectrum Disorder

  • Lena Sagi-DainEmail author
  • Reuven Kedar
  • Mordechai Bardicef
  • Shlomit Riskin
Letter to the Editor

We have read with great interest the paper of Huberman Samuel et al., comparing various perinatal factors between 347 children with autism spectrum disorder (ASD), 117 children with other developmental delays (DD), and 2226 controls (Huberman Samuel et al. 2019). The authors found a significant association between cesarean delivery and ASD—adjusted Odds Ratio 1.371 (95% confidence interval 1.004–1.872), p = 0.047. When analyzed according to the type of anesthesia, the association remained significant only for cesarean deliveries performed under general anesthesia. The authors concluded that reported associations between cesarean delivery and ASD are likely due to the exposure to general anesthesia during the operation.

ASD is a complex neurodevelopmental disorder, characterized by disturbed communication and social interaction, as well as restrictive and repetitive behaviors (Lai et al. 2014). Its prevalence reaches up to 1.5% (i.e. one in 67) in developed countries (Lyall et al. 2017)...


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Conflict of interest

The authors declare that they have no conflict of interest.

Informed Consent

Not relevant for a letter to the editor (not involving research with human participants and/or animals).


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyCarmel Medical CenterHaifaIsrael
  2. 2.Ruth and Bruce Rappaport Faculty of MedicineTechnion – Israel Institute of TechnologyHaifaIsrael

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