No Link Between Labor Induction and Autism, ACOG Says

Lara C. Pullen, PhD

April 24, 2014

The American College of Obstetricians and Gynecologists (ACOG) Committee on Obstetric Practice has determined there is no evidence of a causal relationship between induction of labor and autism spectrum disorders (ASDs). The committee therefore recommends against a change in the current guidance for labor induction and augmentation.

The committee opinion was published in the May issue of Obstetrics & Gynecology.

The committee was formed in response to concern about the relationship between oxytocin and autism. Some individuals with ASD have functional oxytocin deficiency and a faulty oxytocin signaling pathway. Investigators have proposed that the use of synthetic oxytocin during labor induction might affect the expression of fetal oxytocin receptors and predispose exposed neonates to ASD.

A handful of studies have suggested an association between the use of oxytocin for labor induction or augmentation and ASD. These studies have been criticized, however, because of their small size and retrospective data collection.

The ACOG committee reviewed available research evaluating the association between oxytocin for labor induction and augmentation and ASD in children. It was unable to identify a causal relationship between them. The committee notes that there are limitations in available study design, as well as conflicting data between the available studies.

Labor induction and augmentation are performed when immediate delivery is deemed necessary or physicians determine labor is not progressing appropriately. The practice is common and plays a large role in patient care. The committee considered the potential consequences of limiting labor induction and augmentation when making their recommendation.

"In obstetric practice, labor induction and augmentation play an essential role in protecting the health of some mothers and in promoting safe delivery of many babies," Jeffrey L. Ecker, MD, chair of the Committee on Obstetric Practice, which developed the new committee opinion, said in a college news release. "When compared with these benefits, the research we reviewed in assembling this Committee Opinion, relative to the utilization of oxytocin, had clear limitations. Because of this, these studies should not impact how obstetricians already safely and effectively use labor induction and augmentation when caring for their patients."

The authors have disclosed no relevant financial relationships.

Obstet Gynecol. 2014;123:1140-1142. Full text

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