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Brief Report: Maternal Opioid Prescription from Preconception Through Pregnancy and the Odds of Autism Spectrum Disorder and Autism Features in Children

A Correction to this article was published on 20 September 2018

This article has been updated


Opioid use during pregnancy is associated with suboptimal pregnancy outcomes. Little is known about child neurodevelopmental outcomes. We examined associations between maternal opioid prescriptions preconception to delivery (peri-pregnancy) and child’s risk of ASD, developmental delay/disorder (DD) with no ASD features, or ASD/DD with autism features in the Study to Explore Early Development, a case-control study of neurodevelopment. Preconception opioid prescription was associated with 2.43 times the odds of ASD [95% confidence interval (CI) 0.99, 6.02] and 2.64 times the odds of ASD/DD with autism features (95% CI 1.10, 6.31) compared to mothers without prescriptions. Odds for ASD and ASD/DD were non-significantly elevated for first trimester prescriptions. Work exploring mechanisms and timing between peri-pregnancy opioid use and child neurodevelopment is needed.

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  • 20 September 2018

    The original version of this article unfortunately contained a mistake in Table 2. The “Time of use” should be the column header with the corresponding row with “N = 126” belonging to the “Peri-pregnancy” row. The "Preconception" row should be the row with “N = 17”, “Trimester 1” should be the “N = 29” row, “Trimester 2” should be the “N = 25” row, and “Trimester 3” should be the “N = 47” row.


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The investigators acknowledge the contributions made to this study by project staff and enrolled families. A portion of these data were supplied by the Bureau of Health Statistics and Research—PA Department of Health Harrisburg, PA. The PA Department of Health specifically disclaims responsibility for any analysis interpretations or conclusions. This publication was supported by six cooperative agreements from the Centers for Disease Control and Prevention (CDC): Cooperative Agreement Number U10DD000180, Colorado Department of Public Health; Cooperative Agreement Number U10DD000181, Kaiser Foundation Research Institute (CA); Cooperative Agreement Number U10DD000182, University of Pennsylvania; Cooperative Agreement Number U10DD000183, Johns Hopkins University; Cooperative Agreement Number U10DD000184, University of North Carolina at Chapel Hill; and Cooperative Agreement Number U10DD000498, Michigan State University. Eric Rubenstein was additionally supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health under Award Number T32HD007489 and U54 HD090256. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC or NIH.

Author information




Study concept (Eric Rubenstein), study design and methods (all authors), statistical plan (Eric Rubenstein, Julie Daniels, Jessica Young), statistical analysis (Eric Rubenstein), statistical review and interpretation (all authors), manuscript preparation and/or review (all authors).

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Correspondence to Eric Rubenstein.

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Conflict of interest

There are no conflicts of interest to report Eric Rubenstein had full access to all the data in the study and takes responsibility for the integrity of the data and accuracy of the data analysis.

Additional information

Since study completion, Dr. Dowling has moved to the Division of Cancer Prevention and Control within CDC's National Center for Chronic Disease Prevention and Health Promotion.

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Rubenstein, E., Young, J.C., Croen, L.A. et al. Brief Report: Maternal Opioid Prescription from Preconception Through Pregnancy and the Odds of Autism Spectrum Disorder and Autism Features in Children. J Autism Dev Disord 49, 376–382 (2019).

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  • Risk factor
  • Opioid
  • ASD
  • Developmental disorder
  • Pregnancy