Parents of Autistic Children Often Stop Reproducing

Laird Harrison

July 03, 2014

Parents of children with autism often stop trying to have more children once a diagnosis is made, a new study suggests.

Parents whose first child has autism are a third less likely to have a second child compared with parents with a normally developing first child, the researchers found.

"These findings have implications for recurrence risk estimation and genetic counseling," write Thomas J. Hoffmann, PhD, of the Institute for Human Genetics at the University of California, San Francisco, and colleagues.

The study was published online June 18 in JAMA Psychiatry.

Many previous studies have estimated the likelihood that siblings of a child with autism will also have autism. But these estimates could be biased if they do not take into consideration the tendency of parents of affected children to avoid having a second child, researchers write.

To fill that gap, the researchers identified 19,710 first-born children with autism born from 1990 through 2003 in California. The families included 39,361 individuals (siblings and half siblings).

For comparison purposes, the researchers identified a group of 36,215 control families (with 75,724 individuals) in which there was no autism diagnosis.

They found that for the first 3 years after the birth of a child with autism, parents' reproductive behavior was similar to that of the control families.

But birth rates differed in subsequent years. Ultimately, parents of a child with autism had a second child at a rate of 0.668 that of control families.

Women who changed partners after having a child with autism had a slightly stronger curtailment in reproduction. They had second children at 0.553 the rate of families without an autism diagnosis.

This pattern appeared to affect estimates of the risk that a sibling of a child with autism will also have autism.

The researchers estimated that this recurrence risk was 8.7% for full siblings and 3.2% for maternal half siblings, if the tendency of parents to avoid having a second child with autism was not taken into consideration.

But when they took that tendency into consideration ― by including only the children born after the first affected child was born ― the risk increased to 10.1% for full siblings and 4.8% for half siblings.

The study was funded by the Institute for Human Genetics and the National Cancer Institute. The authors have disclosed no relevant financial relationships.

JAMA Psychiatry. Published online June 18, 2014. Abstract

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