Association of Prenatal Ultrasonography and Autism Spectrum Disorder

Rosman, N. Paul; Vassar, Rachel; Doros, Gheorghe; DeRosa, James; Froman, Allison; DiMauro, Audrey; Santiago, Sherry; Abbott, Jodi

doi:10.1001/jamapediatrics.2017.5634

Cited by 21 publications

(20 citation statements)

References 36 publications

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“…In a current study by Rosman et al [86], 211 children with developmental disorders (including 107 cases of ASD) were compared to a control group of 209 children in relation to prenatal ultrasound examinations. There were no differences with respect to the main parameters including examination frequency, examination time, acoustic output power, operating modes, etc.…”

Section: Autismmentioning

confidence: 97%

How safe is it to use ultrasound in prenatal medicine? Facts and contradictions – Part 2 – Laboratory experiments regarding non-thermal effects and epidemiological studies

Dudwiesus¹,

Merz

2021

Ultraschall Med

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The first part of this CME article (issue 5/20) provided a detailed examination of the biophysical effects of ultrasound waves, the exposure values, and in particular the thermal effect. In vivo and in vitro measurements have shown that the temperature increase in tissue associated with B-mode ultrasound is far too low to pose a potential risk. Even experiments with exposure values in the range of pulsed Doppler have shown that temperature increases of over 1.5 °C can only occur in areas in direct contact with the probe, thus making a limited exposure time particularly in the case of transvaginal application advisable. The second part of this CME article describes various laboratory and animal experiments for evaluating non-thermal effects and also presents the most important epidemiological studies in the last 30 years in the form of an overview and review. In addition to direct insonation of isolated cells to examine possible mutagenic effects, the blood of patients exposed in vivo to ultrasound was also analyzed in multiple experiments. Reproducible chromosome aberrations could not be found in any of the studies. In contrast, many experiments on pregnant rodents showed some significant complications, such as abortion, deformities, and behavioral disorders. As in the case of thermal effects, the results of these experiments indicate the presence of an intensity- or pressure-dependent effect threshold. Numerous epidemiological studies examining possible short-term and long-term consequences after intrauterine ultrasound exposure are available with the most important studies being discussed in the following. In contrast to information presented incorrectly in the secondary literature and in the lay press, health problems could not be seen in the children observed in the postpartum period in any of these studies.

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Section: Autismmentioning

confidence: 97%

How safe is it to use ultrasound in prenatal medicine? Facts and contradictions – Part 2 – Laboratory experiments regarding non-thermal effects and epidemiological studies

Dudwiesus¹,

Merz

2021

Ultraschall Med

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“…One study found a possible association between ultrasound exposure and delayed speech development [28], but this was refuted by a randomized trial [29]. Two recent case-control studies with questionable methodology have tried to establish a link between ultrasound exposure in utero and autism [30,31], this association was not found in a large randomized trial [32]. One epidemiological study supports the association between ultrasound exposure and non-right handedness [33].…”

Section: Safety Implicationsmentioning

confidence: 99%

Safety Aspects of Perinatal Ultrasound

et al. 2021

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Ultrasound safety is of particular importance in fetal and neonatal scanning. Fetal tissues are vulnerable and often still developing, the scanning depth may be low, and potential biological effects have been insufficiently investigated. On the other hand, the clinical benefit may be considerable. The perinatal period is probably less vulnerable than the first and second trimesters of pregnancy, and ultrasound is often a safer alternative to other diagnostic imaging modalities. Here we present step-by-step procedures for obtaining clinically relevant images while maintaining ultrasound safety. We briefly discuss the current status of the field of ultrasound safety, with special attention to the safety of novel modalities, safety considerations when ultrasound is employed for research and education, and ultrasound of particularly vulnerable tissues, such as the neonatal lung. This CME is prepared by ECMUS, the safety committee of EFSUMB, with contributions from OB/GYN clinicians with a special interest in ultrasound safety.

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“…12 Likewise, a recent study suggested possible association between fetal ultrasound exposure and autism spectrum disorder. 13 Even if some ultrasound exposure is safe, we cannot assume that any amount is safe, and it is critical for epidemiological data to be updated for current technology and practices.…”

Section: Health Risks and Benefitsmentioning

confidence: 99%

Personal prenatal ultrasound use by women’s health professionals: An ethical analysis

2021

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Prenatal ultrasound use is skyrocketing despite limited evidence of improved outcomes. One factor driving this trend is the widely recognized psychological appeal of real-time fetal imaging. Meanwhile, considering imperfect safety evidence, U.S. professional guidelines dictate that prenatal ultrasound—a screening test—should be governed by expected clinical benefits—an opportunity for intervention. However, when women’s healthcare professionals themselves are pregnant, their access to ultrasound technology permits informal, personal use that may deviate from standard-of-care, e.g., for reassurance. Highlighting a poignant case wherein a pregnant obstetrician’s personal ultrasound use had unforeseen negative consequences, we explore this issue within context of professional ethics and informal medical care. We discuss how women’s health professionals’ self-care may influence and inform prenatal care at large. We advocate curtailing informal prenatal ultrasound use, but also potentially broadening accepted indications for or relaxing proscriptions against ultrasounds for patients. Further research and updated, evidence-based, ethically-sound guidelines are needed.

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Association of Prenatal Ultrasonography and Autism Spectrum Disorder

Cited by 21 publications

References 36 publications

How safe is it to use ultrasound in prenatal medicine? Facts and contradictions – Part 2 – Laboratory experiments regarding non-thermal effects and epidemiological studies

How safe is it to use ultrasound in prenatal medicine? Facts and contradictions – Part 2 – Laboratory experiments regarding non-thermal effects and epidemiological studies

Safety Aspects of Perinatal Ultrasound

Personal prenatal ultrasound use by women’s health professionals: An ethical analysis

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