Letter to the editor regarding "Autism and the obstetrician"

To the Editor:

[Regarding your editorial “Autism and the obstetrician” that appeared in the June 2013 issue of Contemporary OB/GYN:]

Is it possible that individually or in combination, prenatal sonography, fetal heart rate Doppler in the office, and fetal monitoring in the labor room are contributing to the cause of autism? This did not occur with such frequency in the age of the fetoscope.

Martin S. Dubner, MD

Suffern, New York

In Reply:

My short answer is: probably not. Abramowicz recently reviewed this topic and concluded that no independently confirmed peer-reviewed published evidence has established a cause-effect relationship between prenatal exposure to clinical ultrasound and subsequent development of autism spectrum disorders (ASDs).¹ There is a mouse study suggesting that fairly prolonged (30-minute) exposure to diagnostic ultrasound can affect neuronal migration.² However, this experimental design is unlikely to be relevant to clinical exposures in humans.

The timing of the sudden surge in ASD diagnoses does overlap with the rise of prenatal ultrasound. However, most observers believe the bulk of the additional diagnoses reflect improved surveillance.

I hope that helps. Thank you for your interest.

Charles J. Lockwood, MD

Editor in Chief, Contemporary OB/GYN

References

1. Abramowicz JS. Ultrasound and autism: association, link, or coincidence?J Ultrasound Med. 2012;31(8):1261-1269.

2. Ang ES Jr, Gluncic V, Duque A, Schafer ME, Rakic P. Prenatal exposure to ultrasound waves impacts neuronal migration in mice.Proc Natl Acad Sci U S A. 2006;103(34):12903-12910.