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J Autism Dev Disord. 2018 Aug 21. doi: 10.1007/s10803-018-3721-8. [Epub ahead of print]

Brief Report: Maternal Opioid Prescription from Preconception Through Pregnancy and the Odds of Autism Spectrum Disorder and Autism Features in Children.

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Waisman Center, University of Wisconsin-Madison, Rm 529, 1500 Highland Avenue, Madison, WI, 53705, USA.
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina Chapel Hill, 135 Dauer Dr, Chapel Hill, NC, 27599, USA.
Kaiser Permanente Division of Research, 2000 Broadway, Oakland, CA, 94612, USA.
Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus School of Public Health, 13001 E. 17th Place, Aurora, CO, 80045, USA.
National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA.
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.


Opioid use during pregnancy is associated with suboptimal pregnancy outcomes. Little is known about child neurodevelopmental outcomes. We examined associations between maternal opioid prescriptions preconception to delivery (peri-pregnancy) and child's risk of ASD, developmental delay/disorder (DD) with no ASD features, or ASD/DD with autism features in the Study to Explore Early Development, a case-control study of neurodevelopment. Preconception opioid prescription was associated with 2.43 times the odds of ASD [95% confidence interval (CI) 0.99, 6.02] and 2.64 times the odds of ASD/DD with autism features (95% CI 1.10, 6.31) compared to mothers without prescriptions. Odds for ASD and ASD/DD were non-significantly elevated for first trimester prescriptions. Work exploring mechanisms and timing between peri-pregnancy opioid use and child neurodevelopment is needed.


ASD; Developmental disorder; Opioid; Pregnancy; Risk factor


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