Public Release: 

Induced or augmented childbirth appears to be associated with increased risk for autism

The JAMA Network Journals

An analysis of North Carolina birth and educational records suggests that induction (stimulating uterine contractions prior to the onset of spontaneous labor) and augmentation (increasing the strength, duration, or frequency of uterine contractions with spontaneous onset of labor) during childbirth appears to be associated with increased odds of autism diagnosis in childhood, according to a study by Simon G. Gregory, Ph.D., of Duke University Medical Center, Durham, N.C., and colleagues.

Researchers performed an epidemiological analysis of 625,042 live births linked with school records, including 5,500 children with a documented exceptionality designation for autism, using the North Carolina Detailed Birth Record and Education Research databases. Using these records, the researchers examined whether induced births, augmented births, or both are associated with increased odds of autism.

Compared with children born to mothers who received neither labor induction nor augmentation, children born to mothers who were induced and augmented, induced only, or augmented only experienced increased odds of autism after controlling for potential confounders related to socioeconomic status, maternal health, pregnancy-related events and conditions, and birth year. The observed associations between labor induction/augmentation were particularly pronounced in male children, according to the study results.

"While these results are interesting, further investigation is needed to differentiate among potential explanations of the association including underlying pregnancy conditions requiring the eventual need to induce/augment, the events of labor and delivery associated with induction/augmentation, and the specific treatments and dosing used to induce/augment labor," the study concludes.


(JAMA Pediatr. Published online August 12, 2013. doi:10.1001/jamapediatrics.2013.2904. Available pre-embargo to the media at

Editor's Note: This study was supported by funding from the United States Environmental Protection Agency. Please see the articles for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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