Regional Differences in Autism and Intellectual Disability Risk Associated with Cesarean Section Delivery

Share this page

New

Reprint permission request

Author(s)
Deborah Bilder, Scott Sullivan, Michelle Hughes, Susan Dalton, Jennifer A Hall-Lande, Connor Nicholls, Amanda Bakian

Description

Prior epidemiological studies investigating the association between delivery mode (i.e., vaginal birth and cesarean section [C-section]) and autism spectrum disorder (ASD) and intellectual disability (ID) risk have reported mixed findings. This study examined ASD and ID risks associated with primary and repeat C-section within diverse US regions. During even years 2000–2016, 8-years-olds were identified with ASD and/or ID and matched to birth records [ASD only (N = 8566, 83.6% male), ASD + ID (N = 3445, 79.5% male), ID only (N = 6158, 60.8% male)] using the Centers for Disease Control and Prevention's Autism and Developmental Disabilities Monitoring Network methodology. The comparison birth cohort (N = 1,456,914, 51.1% male) comprised all births recorded in the National Center for Health Statistics corresponding to birth years and counties in which surveillance occurred. C-section rates in the birth cohort demonstrated significant regional variation with lowest rates in the West. Overall models demonstrate increased odds of disability associated with primary and repeat C-section. Adjusted models, stratified by region, identified significant variability in disability likelihood associated with repeat C-section: increased odds occurred for all case groups in the Southeast, for ASD only and ID only in the Mid-Atlantic, and no case groups in the West. Regional variability in disability risk associated with repeat C-section coincides with differences in birth cohorts' C-section rates. This suggests increased likelihood of disability is not incurred by the procedure itself, but rather C-section serves as a proxy for exposures with regional variability that influence fetal development and C-section rates.

Suggested Citation

Bilder, D. A., Sullivan, S., Hughes, M. M., Dalton, S., Hall‐Lande, J., Nicholls, C., & Bakian, A. V. (2024). Regional differences in autism and intellectual disability risk associated with cesarean section delivery. Autism Research. https://doi.org/10.1002/aur.3247

Details

Date
2024 
Type
Peer-Reviewed Article 
Publisher
Wiley

Topics

  • Health and safety
    • Healthcare
  • Specific disability
    • Autism spectrum disorder (ASD)
    • Intellectual/developmental disability (IDD)