FAQ: New Research on Pitocin & Autism
Pitocin is used in almost one out of four labors today. Doctors, certified nurse-midwives and our Bon Secours hospitals have been besieged by calls from women who have questions related to the article published on August 12 in JAMA Pediatrics Here are the most frequently asked questions (FAQ) and some information that may help you. Always talk to your own provider for any questions related to your own individual situation; this is a general FAQ sheet that does not take the place of professional advice.
Why was the research done?
- The incidence of Autism Spectrum Disorder (ASD) is about one in 88 children. There is concern that percentage has been increasing (from 1/200 or 1/150) over the last decade, although it is as yet unclear whether there is an actual increase, or if identification and reporting have improved.
- At the same time, the use of Pitocin has also increased significantly from use in one out of 10 pregnancies in 1990 to almost one out of four pregnancies today.
- While there are many studies on the effect of Pitocin on the mother, there have been fewer studies on the effect on the baby. This study looks at the effect on the baby of the use of Pitocin during labor.
What was done in the research?
- Researchers at Duke University and the University of Michigan studied over 600,000 births in North Carolina from 1990-1998 and the 1997-2007 educational records of the children from those pregnancies. They examined the association between labors that were induced (started) or augmented (helped along) with Pitocin.
- Other known issues—like a complication of pregnancy—were carefully analyzed, but there may still be factors we don’t yet know about that were involved in the development of the autism.
- This is a strong study, both because of the large number of pregnancies involved, and the longitudinal (over time) follow-up of the children from those pregnancies.
What were the results of the study?
- Induction or augmentation of labor is associated with between 17% and 26% higher likelihood of childhood ASD than births where Pitocin was not used to start or help labor.
- Baby boys were at higher risk than females.
- Authors of the study note their research does not prove that Pitocin in labor can actually cause autism. Many biologic, environmental, and genetic factors likely also play a role.
What will change?
- In the U.S., we tend to take a more interventional approach to birth than many other countries. For instance, Duchess Kate was eight days overdue for Prince George, and even then she was not induced in Britain, although she may well have been induced in the U.S. Over the last five years more U.S. organizations from the National Institutes of Health (NIH) to the respected Milbank Memorial Fundhave advocated a more careful analysis of the benefits and costs of intervening in pregnancy versus letting nature take its course as long as mother and baby are healthy.
- Within Bon Secours Richmond and Hampton Roads Health Systems and many other health systems nationally, elective (optional) inductions at less than 39 weeks gestation are no longer done. This is based on research and recommendations from organizations like the NIH, the Institute for Healthcare Improvement(IHI) and the American College of Obstetricians and Gynecologists(ACOG).
- There continues to be a growing concern nationally about the use of Pitocin for elective inductions at any stage in pregnancy. Particularly when the uterus is not ready for labor, there is also a higher rate of cesareans with inductions. An index called the Bishop Score can help predict when an induction might end in cesarean.
I am expecting a baby. What does this mean for me?
- No medication has been proven to be completely safe for anyone—and that’s even truer for pregnancy use. We know some are safer than others, but that does not mean we will not find an issue later. While Pitocin has a longer history of use in birth than many medications, that still does not mean it is completely safe.
- We are just now beginning to study—as this research did—the effect of
Pitocin on the baby. There are many more studies that have been done on the
impact of induction on the mother’s health. If you are considering an elective
induction, you might want to know more about your chance of having a cesarean
or other complication from the induction itself. Here are some links that may help you:
ACOG FAQ sheet on induction
Complications and outcomes of induced or spontaneous labor
Elective induction complications in mother and baby
- However, remember there can also be very serious medical complications of pregnancy that threaten the baby’s or mother’s wellbeing. When that happens, those very real risks can and often do outweigh the potential risk of using Pitocin.
- Also remember that we still don’t know if the Pitocin was the cart or the horse in this study, whether Pitocin was a cause or whether something about the pregnancy that we have not yet identified—perhaps even existing early ASD—caused the mother to not go into labor, resulting in the use of Pitocin.
- Only your own physician/provider can counsel you on the risks and options for your particular pregnancy and your baby’s health. As always, discuss your risk factors and potential advantages or contraindications for any medication or procedure during your pregnancy. If you have a concern about the use of Pitocin during labor, discuss it directly with your physician or nurse-midwife; they understand your particular situation.
I was induced, and have had my baby. How can I tell if the baby is alright?
- First, remember that far more babies are healthy than have signs of ASD or other illnesses.
- You can learn the early signs of autism here
- Your first resource should always be your baby’s doctor or nurse practitioner. Tell them your history and concerns, and ask them to check the baby and tell you their findings. They can also recommend other resources for you.