Assisted conception and risk of autism spectrum disorder in a large commercially insured population in the United States
Year: 2017
Type: dissertation
Study design: Observational Study
Abstract: Over the past 4 decades, the prevalence of autism spectrum disorder (ASD) has increased from ~5 per 10,000 persons in the 1970s to current estimates of ~147 per 10,000 persons. Although much of this increase is likely due to changes in diagnostic criteria and ascertainment, it is unclear to what degree true temporal changes in ASD risk are also occurring. Nonetheless, because of their high prevalence and lifelong morbidity associated with the core features, ASDs are a major public health concern. Multiple lines of evidence suggest that peri-conceptional exposures, such as those related to assisted conception, may be of particular interest ASD etiology. Assisted conception (AC), which includes hormonal treatments (i.e. ovulation-inducing drugs, OID) as well as technical procedures (i.e. in vitro fertilization, IVF; intrauterine insemination, IUI), has been investigated as a potential obstetric risk factor for ASD in around 15 original research studies, as well as several systematic reviews/meta-analyses, with inconsistent results. Only a single study identified a statistically significant inverse relationship. And though several studies have found statistically significant positive associations between use of AC and risk of ASD, few have found that statistical significance persisted either for the main outcome or a subgroup after adjustment for potential confounders and covariates of interest. This project has examined the potential association between AC, according to type of AC treatment, and risk of ASD through prospectively generated data available on a large commercially insured population. The identification of modifiable risk factors is vital to the development of strategies to reduce ASD risk.
DOI: 10.17918/etd-7734
Institutions: University of Dhaka, Drexel University
Language: English
Subfield: Cognitive Neuroscience
Field: Neuroscience
Domain: Life Sciences
Open Access status: gold
OpenAlex ID: W4206387867