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J Dev Behav Pediatr. 2014 Jul-Aug;35(6):353-9. doi: 10.1097/DBP.0000000000000070.

Bone fractures in children with autistic spectrum disorder.

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  • 1*Department of Gastroenterology and Nutrition, University Children's Hospital (UKBB), Basel, Switzerland; †Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland; ‡Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, Lexington, MA; and §Hospital Pharmacy, University Hospital Basel, Basel, Switzerland.



Bone fractures in children represent a source of significant disability and morbidity. Are children with autistic spectrum disorder (ASD) at an altered risk of fractures compared with typically developing children?


Using the General Practice Research Database, the authors assessed the prevalence of fractures in boys with ASD diagnosed between 2 and 8 years. A cross-sectional design was used to compare the prevalence of fractures among children with ASD and age-matched controls, conditional logistic regression to explore the relative risk of having a fracture in association with diagnosed ASD.


The study population comprised 3,219 boys with a first-time diagnosis of ASD and 12,265 matched controls. ASD was associated with a significantly decreased risk of developing a fracture at any time in childhood (odds ratio [OR], 0.68, 95% confidence interval [CI], 0.59-0.77, p < .0001). The relative risk estimates were lower for the time period after ASD diagnosis (OR, 0.56, 95% CI, 0.48-0.66, p < .0001) but were not different for the time period before ASD diagnosis (OR, 0.96, 95% CI, 0.78-1.18, p = .6866). Adjusting for use of different drugs did not change the estimates.


The relative risk of experiencing a fracture at any time in childhood is lower for boys with ASD compared with healthy boys.

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