Abstract
Cesarean section (CS) has been consistently associated with susceptibility to autism spectrum disorder (ASD), however, the underlying mechanism for this association remains vague. Here, we studied various pre-peri-and-neonatal factors among 347 children with ASD, 117 children with other developmental delays (DD), and 2226 age, sex and ethnicity matched controls. We found that CS is significantly associated with an increased risk of ASD but not DD (p = 0.019 and p = 0.540 respectively). Furthermore, we show that only CS performed with general anesthesia (GA) elevated the risk of ASD with no significant difference between indicated and non-indicated surgeries (aOR = 1.537; 95% CI 1.026–2.302, and aOR = 1.692; 95% CI 1.057–2.709, pdiff = 0.865). We therefore suggest that exposure to GA during CS may explain the association between CS and ASD.
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This research was supported by Grant No. 527/15 from the Israeli Science Foundation (ISF).
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MHS helped to design the study, performed the statistical analyses, and drafted the manuscript. GM participated in the design and interpretation of the data. ID participated in the design and interpretation of the data and helped in drafting the manuscript. HF participated in the design and coordination of the study. AM participated in the design and coordination of the study. AB participated in the design and interpretation of the data and helped in drafting the manuscript. IM conceived the study, guided the statistical analyses, participated in the design and interpretation of the data, and drafted the manuscript. All authors read and approved the final manuscript.
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Huberman Samuel, M., Meiri, G., Dinstein, I. et al. Exposure to General Anesthesia May Contribute to the Association between Cesarean Delivery and Autism Spectrum Disorder. J Autism Dev Disord 49, 3127–3135 (2019). https://doi.org/10.1007/s10803-019-04034-9
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DOI: https://doi.org/10.1007/s10803-019-04034-9