OBs: No Link Between Labor Induction And Autism

The nation's most influential group of obstetrician-gynecologists concludes that there's no connection between labor induction and autism. Earlier reports suggested that there's was a possible link, but even that research, published in JAMA Pediatrics, was complicated and somewhat murky.

Current evidence does not support a conclusion that labor induction or augmentation causes autism spectrum disorder (ASD) in newborns, according to a new Committee Opinion released by the American College of Obstetricians and Gynecologists (the College).

While some studies have suggested an association between ASD and the use of oxytocin for labor induction or augmentation, available evidence is inconsistent and does not demonstrate causation, according to the opinion, which also found important limitations in study design and conflicting findings in existing research.

Given the potential consequences of limiting labor induction and augmentation, the College’s Committee on Obstetric Practice recommends against changes to existing guidance regarding counseling and indications for, and methods of, labor induction and augmentation.

“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,” said Jeffrey L. Ecker, MD. Dr. Ecker is chair of the Committee on Obstetric Practice, which developed the new Committee Opinion. “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 Committee reviewed research evaluating the association between oxytocin – commonly administered for labor induction and augmentation – and ASD in children. As noted in the Opinion, these studies have “a number of limitations, such as small size, retrospective data collection, and limited control for possible confounding variables.”

Importantly, as described in “Labor Induction or Augmentation and Autism,” any discussion about labor induction must take into account the impact on clinical obstetric practice, where labor induction and augmentation play a large role in patient care. Reducing appropriate use of labor induction would almost certainly increase the cesarean delivery rate and, as a consequence, could adversely impact the health outcomes of both the mother and the child.