Is Hyperemesis Gravidarum Associated with an Increased Risk for Autism?
BACKGROUND AND PURPOSE:
Getahun et al. (American Journal of Perinatology,
2019) analyzed whether HG is associated with increased risk of autism spectrum
disorder (ASD), and whether this association can be modified by race,
ethnicity, sex, exposure timing, and the medication used to treat hyperemesis
Retrospective longitudinal cohort study
Mother-child pairs (1991 to 2014)
Singleton birth between 28w0d and 42w6d
Children followed from 2 to 17 years
Clinical records used to diagnosis HG and (specialist-confirmed)
diagnosis of ASD
469,789 mother-child pairs were included
Children exposed to HG in-utero had higher rates
Exposed to HG: 2.87/1,000 person-years
Not exposed: 1.71/1,000 person-years
adjusted hazard ratio (aHR) 1.53 (95% CI, 1.37
Timing of exposure: First HG diagnosis in the
first trimester exposure was associated with increased risk for ASD compared to
Hazard ratio: 1.58 (95% CI: 1.40–1.79)
HG was associated with ASD for both boys and
Boys: aHR: 1.50 (95% CI: 1.33–1.70)
Girls: aHR: 1.62 (95% CI: 1.28–2.05)
HG treatment medications were not associated
with increased risk for ASD
HG may be associated with increased ASD risk
The authors suggest that knowing ASD risk may help
identify children who may benefit from early intervention programs
Authors acknowledge limitations of the study
design and that the data do not prove causation
However, “HG fulfills the Bradford–Hill criteria
as a risk factor in terms of biological plausibility and timing”
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