Thursday, August 15, 2013

When All Else Fails, Blame The Obstetrician

Now that the vaccine-autism link has been debunked again, Jenny McCarthy notwithstanding, everything but the kitchen sink is being put forth as potential causes of this affliction. The latest out of Duke finds a connection between autism and induction of labor.

... Overall, the likelihood of autism increased by 23% in association with induced or augmented labor as compared with children whose mothers had unassisted labor, Simon G. Gregory, PhD, of Duke University, and colleagues reported inJAMA Pediatrics.


Induction only, augmentation only, or the combination all were associated with significantly increased odds of autism. The magnitude of increased risk was similar to that associated with fetal distress, meconium, prematurity, and maternal diabetes, they said.
Curiously, this linkage seemed to hold predominantly for boys. The connection for females was more tenuous.
While this is certainly interesting, remember that association hardly proves cause and effect. Emily Willingham in Forbes gives this article a thorough review and notes some quite strange findings. For one thing, moms' having a college education increase the odds of her child attending special education. Yes, you read that right. Also, maternal smoking apparently decreases the risk of later autism diagnosis. So should we infer that women should drop out of school and commence smoking? Hardly.
While the dust settles around this study, remember that there have been numerous studies linking various genetic factors and autism, the latest trumpeted by the New York Times. Here's a thought - perhaps whatever genetic or epigenetic factor which may lead to autism spectrum may also predispose to a situation which subsequently require induction of labor. 
Remember that as Mark Twain ( often attributed to Benjamin Disraeli) said, there are "lies, damned lies, and statistics." I learned in high school that statistics are like bikinis - what they reveal is suggestive but what they conceal is vital. 

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