Perinatal and Neonatal Complications in Autism Etiology
A vast and continually growing literature has examined peri- and neonatal factors in association with autism. Factors acting during this time period have particular relevance to autism due to potential influence on brain development. This chapter focuses on perinatal and neonatal complications, as well as maternal substance use, in association with autism. The perinatal complications with strongest evidence for an association with autism include general obstetric suboptimality, gestational diabetes, maternal medication use during pregnancy, bleeding during pregnancy, and multiple births. The neonatal complications with strongest evidence for an association with autism include, again, general occurrence of a range of complications, congenital malformations, low Apgar scores, and markers of hypoxia such as respiratory distress. The nature of associations with these complications has not been fully explained; while certain individual factors may increase risk of autism, associations may also be due to shared genetic risk or correlations between the factors. Future research studies are needed to clarify how these and other factors acting during the perinatal time period influence the development of autism.