International Meeting for Autism Research: Association Between Ovulation Inducing Drug Use, Infertility, and Autism Spectrum Disorders in the Nurses' Health Study II

Association Between Ovulation Inducing Drug Use, Infertility, and Autism Spectrum Disorders in the Nurses' Health Study II

Thursday, May 20, 2010: 10:15 AM
Grand Ballroom AB Level 5 (Philadelphia Marriott Downtown)
10:00 AM
K. Lyall , Epidemiology, Harvard School of Public Health, Boston, MA
D. L. Pauls , Massachusetts General Hospital, Boston, MA
S. L. Santangelo , Center for Human Genetic Research, Psychiatric & Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, MA
D. Spiegelman , Epidemiology, Harvard School of Public Health, Boston, MA
A. Ascherio , Epidemiology, Harvard School of Public Health, Boston, MA
Background: An increasing number of women are utilizing fertility treatments, and the safety of these therapies has been studied with regard to a number of perinatal outcomes. However, the relationship between infertility, fertility treatments, and autism spectrum disorders remains understudied.  

Objectives: To determine whether infertility and use of ovulation-inducing drugs are associated with risk of having a child with an autism spectrum disorder. Methods: We conducted a cohort study of participants from the Nurses Health Study II, a cohort of U.S. female nurses initiated to assess risk of cancer and other major diseases.  Participants have reported their reproductive and medical history since 1989, and disorders in their children in 2005. 3,985 cohort participants who had their first child between 1993 and 2003 and completed a questionnaire including information on autism spectrum disorder in 2005 were included in our analyses. Logistic regression was used to obtain odds ratios for having a child with autism spectrum disorder according to self-reported history of infertility and use of ovulation inducing drugs.

Results: The 111 mothers who reported a child with autism spectrum disorder reported both use of ovulation inducing drugs (34.2%) and infertility (46.8%) more commonly than the 3,874 comparison mothers (23.8 % and 32.6% respectively). After adjustment for pregnancy complications, maternal age, and other possible autism risk factors, the odds  ratio comparing women reporting infertility and use of ovulation inducing drugs to those who reported neither was 1.91 ( 95% CI 1.20, 3.05; p =0.007). History of infertility was also significantly associated with autism spectrum disorders (OR=1.81, 95% CI 1.20, 2.72, p=0.005), though not when accounting for ovulation-inducing drug use (OR=1.58, 95% CI 0.89, 2.82). The odds ratio for autism spectrum disorder increased with the number of reports of use of ovulation inducing drugs (p for trend = 0.008). 

Conclusions: These preliminary results suggest that maternal use of ovulation inducing drugs should be considered as a potential risk factor for autism spectrum disorders in future studies.

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