Department of Economics and Business Economics

Caesarean section and risk of autism across gestational age: a multi-national cohort study of 5 million births

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Caesarean section and risk of autism across gestational age : a multi-national cohort study of 5 million births. / Yip, Benjamin Hon Kei; Leonard, Helen; Stock, Sarah; Stoltenberg, Camilla; Francis, Richard W; Gissler, Mika; Gross, Raz; Schendel, Diana; Sandin, Sven.

In: International Journal of Epidemiology, Vol. 46, No. 2, 2017, p. 429–439.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

Harvard

Yip, BHK, Leonard, H, Stock, S, Stoltenberg, C, Francis, RW, Gissler, M, Gross, R, Schendel, D & Sandin, S 2017, 'Caesarean section and risk of autism across gestational age: a multi-national cohort study of 5 million births', International Journal of Epidemiology, vol. 46, no. 2, pp. 429–439. https://doi.org/10.1093/ije/dyw336

APA

Yip, B. H. K., Leonard, H., Stock, S., Stoltenberg, C., Francis, R. W., Gissler, M., Gross, R., Schendel, D., & Sandin, S. (2017). Caesarean section and risk of autism across gestational age: a multi-national cohort study of 5 million births. International Journal of Epidemiology, 46(2), 429–439. https://doi.org/10.1093/ije/dyw336

CBE

Yip BHK, Leonard H, Stock S, Stoltenberg C, Francis RW, Gissler M, Gross R, Schendel D, Sandin S. 2017. Caesarean section and risk of autism across gestational age: a multi-national cohort study of 5 million births. International Journal of Epidemiology. 46(2):429–439. https://doi.org/10.1093/ije/dyw336

MLA

Vancouver

Yip BHK, Leonard H, Stock S, Stoltenberg C, Francis RW, Gissler M et al. Caesarean section and risk of autism across gestational age: a multi-national cohort study of 5 million births. International Journal of Epidemiology. 2017;46(2):429–439. https://doi.org/10.1093/ije/dyw336

Author

Yip, Benjamin Hon Kei ; Leonard, Helen ; Stock, Sarah ; Stoltenberg, Camilla ; Francis, Richard W ; Gissler, Mika ; Gross, Raz ; Schendel, Diana ; Sandin, Sven. / Caesarean section and risk of autism across gestational age : a multi-national cohort study of 5 million births. In: International Journal of Epidemiology. 2017 ; Vol. 46, No. 2. pp. 429–439.

Bibtex

@article{a51417a572ef4241ad1e29395e7cd65a,
title = "Caesarean section and risk of autism across gestational age: a multi-national cohort study of 5 million births",
abstract = "BACKGROUND: The positive association between caesarean section (CS) and autism spectrum disorder (ASD) may be attributed to preterm delivery. However, due to lack of statistical power, no previous study thoroughly examined this association across gestational age. Moreover, most studies did not differentiate between emergency and planned CS.METHODS: Using population-based registries of four Nordic countries and Western Australia, our study population included 4 987 390 singletons surviving their first year of life, which included 671 646 CS deliveries and 31 073 ASD children. We used logistic regression to estimate odds ratios (OR) and their 95% confidence intervals (CI) for CS, adjusted for gestational age, site, maternal age and birth year. Stratified analyses were conducted by both gestational age subgroups and by week of gestation. We compared emergency versus planned CS to investigate their potential difference in the risk of ASD.RESULTS: Compared with vaginal delivery, the overall adjusted OR for ASD in CS delivery was 1.26 (95% CI 1.22-1.30). Stratified ORs were 1.25 (1.15-1.37), 1.16 (1.09-1.23), 1.34 (1.28-1.40) and 1.17 (1.04-1.30) for subgroups of gestational weeks 26-36, 37-38, 39-41 and 42-44, respectively. CS was significantly associated with risk of ASD for each week of gestation, from week 36 to 42, consistently across study sites (OR ranged 1.16-1.38). There was no statistically significant difference between emergency and planned CS in the risk of ASD.CONCLUSION: Across the five countries, emergency or planned CS is consistently associated with a modest increased risk of ASD from gestational weeks 36 to 42 when compared with vaginal delivery.",
keywords = "Adolescent, Adult, Autism Spectrum Disorder/epidemiology, Cesarean Section/adverse effects, Child, Cohort Studies, Emergencies, Female, Gestational Age, Humans, Infant, Newborn, International Cooperation, Logistic Models, Male, Pregnancy, Registries, Scandinavian and Nordic Countries/epidemiology, Western Australia/epidemiology, Young Adult",
author = "Yip, {Benjamin Hon Kei} and Helen Leonard and Sarah Stock and Camilla Stoltenberg and Francis, {Richard W} and Mika Gissler and Raz Gross and Diana Schendel and Sven Sandin",
note = "{\textcopyright} The Author 2016; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.",
year = "2017",
doi = "10.1093/ije/dyw336",
language = "English",
volume = "46",
pages = "429–439",
journal = "International Journal of Epidemiology",
issn = "0300-5771",
publisher = "Oxford University Press",
number = "2",

}

RIS

TY - JOUR

T1 - Caesarean section and risk of autism across gestational age

T2 - a multi-national cohort study of 5 million births

AU - Yip, Benjamin Hon Kei

AU - Leonard, Helen

AU - Stock, Sarah

AU - Stoltenberg, Camilla

AU - Francis, Richard W

AU - Gissler, Mika

AU - Gross, Raz

AU - Schendel, Diana

AU - Sandin, Sven

N1 - © The Author 2016; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

PY - 2017

Y1 - 2017

N2 - BACKGROUND: The positive association between caesarean section (CS) and autism spectrum disorder (ASD) may be attributed to preterm delivery. However, due to lack of statistical power, no previous study thoroughly examined this association across gestational age. Moreover, most studies did not differentiate between emergency and planned CS.METHODS: Using population-based registries of four Nordic countries and Western Australia, our study population included 4 987 390 singletons surviving their first year of life, which included 671 646 CS deliveries and 31 073 ASD children. We used logistic regression to estimate odds ratios (OR) and their 95% confidence intervals (CI) for CS, adjusted for gestational age, site, maternal age and birth year. Stratified analyses were conducted by both gestational age subgroups and by week of gestation. We compared emergency versus planned CS to investigate their potential difference in the risk of ASD.RESULTS: Compared with vaginal delivery, the overall adjusted OR for ASD in CS delivery was 1.26 (95% CI 1.22-1.30). Stratified ORs were 1.25 (1.15-1.37), 1.16 (1.09-1.23), 1.34 (1.28-1.40) and 1.17 (1.04-1.30) for subgroups of gestational weeks 26-36, 37-38, 39-41 and 42-44, respectively. CS was significantly associated with risk of ASD for each week of gestation, from week 36 to 42, consistently across study sites (OR ranged 1.16-1.38). There was no statistically significant difference between emergency and planned CS in the risk of ASD.CONCLUSION: Across the five countries, emergency or planned CS is consistently associated with a modest increased risk of ASD from gestational weeks 36 to 42 when compared with vaginal delivery.

AB - BACKGROUND: The positive association between caesarean section (CS) and autism spectrum disorder (ASD) may be attributed to preterm delivery. However, due to lack of statistical power, no previous study thoroughly examined this association across gestational age. Moreover, most studies did not differentiate between emergency and planned CS.METHODS: Using population-based registries of four Nordic countries and Western Australia, our study population included 4 987 390 singletons surviving their first year of life, which included 671 646 CS deliveries and 31 073 ASD children. We used logistic regression to estimate odds ratios (OR) and their 95% confidence intervals (CI) for CS, adjusted for gestational age, site, maternal age and birth year. Stratified analyses were conducted by both gestational age subgroups and by week of gestation. We compared emergency versus planned CS to investigate their potential difference in the risk of ASD.RESULTS: Compared with vaginal delivery, the overall adjusted OR for ASD in CS delivery was 1.26 (95% CI 1.22-1.30). Stratified ORs were 1.25 (1.15-1.37), 1.16 (1.09-1.23), 1.34 (1.28-1.40) and 1.17 (1.04-1.30) for subgroups of gestational weeks 26-36, 37-38, 39-41 and 42-44, respectively. CS was significantly associated with risk of ASD for each week of gestation, from week 36 to 42, consistently across study sites (OR ranged 1.16-1.38). There was no statistically significant difference between emergency and planned CS in the risk of ASD.CONCLUSION: Across the five countries, emergency or planned CS is consistently associated with a modest increased risk of ASD from gestational weeks 36 to 42 when compared with vaginal delivery.

KW - Adolescent

KW - Adult

KW - Autism Spectrum Disorder/epidemiology

KW - Cesarean Section/adverse effects

KW - Child

KW - Cohort Studies

KW - Emergencies

KW - Female

KW - Gestational Age

KW - Humans

KW - Infant, Newborn

KW - International Cooperation

KW - Logistic Models

KW - Male

KW - Pregnancy

KW - Registries

KW - Scandinavian and Nordic Countries/epidemiology

KW - Western Australia/epidemiology

KW - Young Adult

UR - http://www.scopus.com/inward/record.url?scp=85045564095&partnerID=8YFLogxK

U2 - 10.1093/ije/dyw336

DO - 10.1093/ije/dyw336

M3 - Journal article

C2 - 28017932

VL - 46

SP - 429

EP - 439

JO - International Journal of Epidemiology

JF - International Journal of Epidemiology

SN - 0300-5771

IS - 2

ER -