Oxytocin for labour induction or augmentation as a risk factor for autism: systematic literature review

Abstract

Introduction: Some studies have shown a potential association between oxytocin use during labour and autism spectrum disorder (ASD) in children. We performed a systematic review of recent studies examining this association. Methods: Boolean operators (AND/OR) were used to search MEDLINE using the following search criteria: Autistic Disorder or Autism Spectrum Disorder or Autism and Labour Induction or Labour Augmentation. Articles published in English in 2013 or later were considered. Additional studies were identified by reviewing citations. Only studies conducted on people were included. Studies not accounting for potential confounding factors were excluded. Results: Four retrospective cohort studies met the inclusion criteria. One showed an association between labour induction and augmentation and ASD, one showed a weak association between labour augmentation in boys and ASD, and one showed no association between labour induction or augmentation and ASD. The largest study showed a weak association between labour induction and ASD, which was not significant when siblings were analyzed separately. Discussion and conclusion: Recently published studies do not support the hypothesis of a causal relationship between oxytocin use during labour and ASD. Benefits of medically indicated induction or augmentation of labour outweigh the theoretical risk of ASD. IZVLEČEKUvod: Raziskave so pokazale morebitno povezavo med uporabo oksitocina med porodom in avtizmom. Skozi sistematični pregled literature so bile preverjene novejše klinične raziskave s področja povezave med sprožitvijo ali pospeševanjem poroda z oksitocinom in avtizmom. Metode: Z Boolovima operatorjema (AND oz. OR) je bila pregledana bibliografska zbirka MEDLINE s ključnimi besedami avtistična motnja ali spekter avtističnih motenj ali avtizem in sprožitev poroda ali pospeševanje poroda. Vključeni so bili znanstveni članki v angleščini, objavljeni od leta 2013 dalje. Dodatne raziskave so bile identificirane s pregledom citatov. Vključene so bile le raziskave na ljudeh. Izključene so bile raziskave, ki so povezavo med oksitocinom in avtizmom preučevale brez ustreznega upoštevanja morebitnih motečih dejavnikov. Rezultati: Vključitvenim kriterijem so ustrezale štiri retrospektivne kohortne raziskave. Povezavo med uporabo oksitocina med porodom in avtizmom je ena raziskava pokazala pri sprožitvi ali pospeševanju poroda, ena samo pri pospeševanju poroda pri dečkih, ena povezave ni pokazala niti pri sprožitvi niti pri pospeševanju poroda, četrta, največja raziskava je pokazala morebitno šibko povezavo pri sprožitvi poroda, vendar ob analizi sorojencev le-ta ni bila več statistično pomembna. Diskusija in zaključek: Do danes objavljene raziskave niso pokazale klinično pomembne vzročne povezave med uporabo oksitocina med porodom in avtizmom. Dokazane koristi medicinsko indicirane uporabe oksitocina odtehtajo teoretično tveganje za nastanek avtizma.