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Neurosciences (Riyadh). 2019 Jan;24(1):11-15. doi: 10.17712/nsj.2019.1.20180303.

Is cesarean section delivery associated with autism spectrum disorder?

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Department of Family and Community Medicine, College of Medicine, Al-Madina Al-Munawarah, Kingdom of Saudi Arabia. E-mail:



To investigate a correlation between birth by caesarean section and autism spectrum disorder (ASD).


A case-control study with a case to control ratio of 1:2 was performed in Al-Madina Al-Munawarah city, Kingdom of Saudi Arabia during the year 2016. The cases were selected according to the eligibility criteria and children attending a well-baby clinic in the same hospital, were chosen as the control group subjects. Data was collected from the medical records and an interview-based questionnaire was administered to the mothers. The chi-square test was used for bivariate analysis and logistic regression to estimate the crude and adjusted odds ratios (ORs).


Eighty-seven cases of ASD and 174 control group subjects were included in the current study. Approximately 39% (n=34) of the 87 children with ASD were delivered by cesarean section compared to 21% (n=36) of the 174 children in the control group. After adjusting for potentially confounding factors, the adjusted OR was 2.9 (95% confidence interval [CI]: 1.57-5.35).


An association between delivery by cesarean section and ASD was found in this study, in support of the findings of other studies. It is recommended that preventive measures are adopted to avoid unnecessary cesarean sections.

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