American Public Health Association - Association Between Assisted Reproductive Technology Conception and Autism in California, 1997–2007

Objectives. We assessed the
association between assisted reproductive technology (ART) and diagnosed
autistic disorder in a population-based sample of California births.
We performed an observational cohort study using linked records from
the California Birth Master Files for 1997 through 2007, the California
Department of Developmental Services autism caseload for 1997 through
2011, and the Centers for Disease Control and Prevention’s National ART
Surveillance System for live births in 1997 through 2007. Participants
were all 5 926 251 live births, including 48 865 ART-originated infants
and 32 922 cases of autism diagnosed by the Department of Developmental
Services. We compared births originated using ART with births originated
without ART for incidence of autism.

Results. In the full
population, the incidence of diagnosed autism was twice as high for ART
as non-ART births. The association was diminished by excluding mothers
unlikely to use ART; adjustment for demographic and adverse prenatal and
perinatal outcomes reduced the association substantially, although
statistical significance persisted for mothers aged 20 to 34 years.

Conclusions. The association between ART and autism is primarily explained by adverse prenatal and perinatal outcomes and multiple births.

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