For Multiple Births More Research Is Needed
OAKLAND, Calif., Month, Day, 2012 – In a new study, neither infertility history nor treatment for infertility was associated with risk of autism spectrum disorder (ASD) among singleton births. For multiple births, the results suggest that there may be some increase in risk of ASD associated with infertility history or treatment, but study researchers emphasize that more research is needed.
The study, which appears in the current issue of the Journal of Autism and Development Disorders, was led by researchers from The California Department of Public Health and Kaiser Permanente Division of Research working in collaboration with scientists from UCSF and Samuel Merritt University. The studyis among the first to address the important question of whether a history of infertility or treatment for infertility is associated with an increased risk of ASD in children. “One reason this question has raised so much scientific and public concern”, said the researchers, “is that infertility is more common in older women, and for reasons not yet fully understood, older women are also at somewhat higher risk of having a child with ASD.”
“We found no evidence that infertility history or treatments increase the risk of ASD in singleton children” said Judith K Grether, PhD, the study’s lead author, formerly with the California Department of Public Health. “For multiple births, our results are less clear and more research is needed.”
”Because the number of multiple births in the study was too small for statistical adjustment for all demographic characteristics and because we lacked detailed data on most infertility treatments, further research is needed,” explained Lisa Croen, PhD, Director of the Kaiser Permanente Autism Research Program and a co-author on the study.
Researchers compared maternal medical record data on children with ASD (cases) and control children to evaluate infertility history and treatments for members of Kaiser Permanente in Northern California. The study population included 77, 403 children who were born in a Kaiser Pernanente Northern California facility from 1995-1998 and remained health plans members for at least two years following birth. From this population, children were identified as ASD cases if they had at least one diagnosis of ASD recorded in Kaiser Permanente Northern California data bases. For each child with ASD, researchers randomly selected five controls from the same study population. Infertility information was gathered from the mother’s medical records at Kaiser and from many specialty infertility clinics serving the same geographic region.
“As in any study of this type, there may be underlying factors we could not measure that explain our results,” said the researchers. “Most important, our findings on multiple births should be considered as very tentative given the small number of multiple birth children in this study and the lack of detailed data on infertility treatments. Also, as new treatments for infertility become available, new studies will be needed.”
Additional authors on the study include: Yinge Qian, with the Kaiser Permanente Division of Research; Mary S Croughan, PhD, with the UCSF Office of the President, Department of Obstetrics, Gynecology and Reproductive Sciences and the Department of Epidemiology and Biostatistics; Yvonne W. Wu, MD, MPH, with the UCSF Department of Neurology and Pediatrics; Michael Schembri, B.S. with the UCSF Department of Obstetrics, Gynecology and Reproductive Sciences; and Loretta Camarano, PhD, with the Samuel Merritt University School of Nursing. The study was funded by the Center for Disease Control and Prevention and, in part, by the National Cancer Institute, the National Institute of Child Health and Human Development, and the Kaiser Foundation Research Institute.
About the California Department of Public Health, Environmental Health Investigations Branch (EHIB)
The California Department of Public Health EHIB works to optimize the health of the people in California by studying how the environment affects health and by educating and informing the public. The environment is the world around us, it is where we live, work and play. We come into contact with the environment through the air we breathe, the food we eat, and the water we drink. Visit our “Learn” pages to understand more about environmental health.
About the Kaiser Permanente Division of Research
The Kaiser Permanente Division of Research conducts, publishes and disseminates epidemiologic and health services research to improve the health and medical care of Kaiser Permanente members and the society at large. It seeks to understand the determinants of illness and well-being and to improve the quality and cost-effectiveness of health care. Currently, DOR’s 600-plus staff is working on more than 250 epidemiological and health services research projects.
About Kaiser Permanente
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high-quality, affordable health care services to improve the health of our members and the communities we serve. We currently serve 8.6 million members in nine states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: www.kp.org/newscenter. https://www.kaiserpermanente.org
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