Abstract
Objective:
This study aims to determine whether fetal meconium passage is associated with autism.
Study Design:
This retrospective birth cohort analysis of 9 945 896 children born in California 1991 to 2008 linked discharge diagnosis and procedure codes for prenatal stressors, meconium-stained amniotic fluid (MSAF) and meconium aspiration syndrome (MAS) with autism diagnoses for 47 277 children through 2012. We assessed the relative risk of autism by meconium status using logistic regression, adjusting for demographic and clinical features.
Results:
Children exposed to meconium (MSAF and MAS) were more likely to be diagnosed with autism in comparison with unexposed children (0.60% and 0.52%, vs 0.47%, respectively). In adjusted analyses, there was a small increase in autism risk associated with MSAF exposure (adjusted relative risk (aRR) 1.18, 95% confidence interval (CI) 1.12 to 1.25), and a marginal association that failed to achieve significance between MAS and autism (aRR 1.08, 95% CI 0.98 to 1.20).
Conclusion:
Resuscitation of neonates with respiratory compromise from in utero meconium exposure may mitigate long-term neurodevelopmental damage.
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Acknowledgements
This publication was made possible by a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Grant #1R03HD074911-01, and a Medical Student Research Fellowship grant from the University of California, Davis School of Medicine (KM). The funders had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and the decision to submit the manuscript for publication. The contents of this publication are solely the responsibility of the grantees and do not necessarily represent the official views of the funding agencies. Furthermore, the funders do not endorse the purchase of any commercial products mentioned in the publication. The UC Davis School of Medicine’s Medical Student Research Fellowship provided structure, motivation and support for Ms Miller’s work in the development of this project and the writing of the manuscript. We thank the California’s Department of Public Health, Department of Developmental Services, Office of Statewide Planning and Health Development and Vital Statistics for access to data for this project. This project would not have been possible without the expertize of Beate Danielsen, PhD (Health Information Solutions) who merged these data sets. Findings from this work were presented in poster format at the International Meeting for Autism Research, May 2015.
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Dr Walker serves on the Speaker’s Bureau for Merck & Co. This work pertains neither to pregnancy complications nor to neurodevelopment.
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Miller, K., Xing, G. & Walker, C. Meconium exposure and autism risk. J Perinatol 37, 203–207 (2017). https://doi.org/10.1038/jp.2016.200
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DOI: https://doi.org/10.1038/jp.2016.200
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