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Paediatr Perinat Epidemiol. 2012 Jul;26(4):361-72. doi: 10.1111/j.1365-3016.2012.01294.x.

Fertility therapies, infertility and autism spectrum disorders in the Nurses' Health Study II.

Author information

  • 1Department of Nutrition, Harvard School of Public Health, Boston, MA, USA. klyall@hsph.harvard.edu

Abstract

BACKGROUND:

An increasing number of women are utilizing fertility treatments, but little is known about their relation to autism spectrum disorders (ASD).

METHODS:

To determine the association between maternal fertility therapy use and risk of having a child with ASD, we conducted a nested case-control study within the Nurses' Health Study II (n = 116,430). Maternally reported diagnoses of ASD were confirmed through a supplementary questionnaire and, in a subgroup, the Autism Diagnostic Interview-Revised. Controls were randomly selected by frequency matching to case children's year of birth. Associations were examined by self-reported infertility and type of therapy using conditional logistic regression.

RESULTS:

In all, 9% of the 507 cases and 7% of 2,529 controls indicated fertility therapy use for the index pregnancy. No significant associations with self-reported fertility therapies or history of infertility were seen in primary analyses. In subgroup analyses of women with maternal age ≥ 35 years (n = 1,020), artificial insemination was significantly associated with ASD; ovulation inducing drug (OID) use was significantly associated in crude but not adjusted analyses (odds ratio 1.81, 95% CI 0.96-3.42). Results were similar by diagnostic subgroup, though within the advanced maternal age group, OID and artificial insemination were significantly associated with Asperger syndrome and pervasive developmental disorder not-otherwise specified, but not autistic disorder.

CONCLUSION:

[corrected] Assisted reproductive therapy and history of infertility did not increase risk of having a child with ASD in this study. However, the associations observed with OID and artificial insemination among older mothers, for whom these exposures are more common, warrant further investigation.

© 2012 Blackwell Publishing Ltd.

PMID:
22686388
[PubMed - indexed for MEDLINE]
PMCID:
PMC3494409
Free PMC Article
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