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Published on: April 22, 2015
Bone fractures in children with autistic spectrum disorder
Raoul I Furlano1, Marlene Bloechliger, Hershel Jick
1*Department of Gastroenterology and Nutrition, University Children's Hospital (UKBB), Basel, Switzerland; †Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland; ‡Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, Lexington, MA; and §Hospital Pharmacy, University Hospital Basel, Basel, Switzerland.
Background:
Bone fractures in children represent a source of significant disability and morbidity. Are children with autistic spectrum disorder (ASD) at an altered risk of fractures compared with typically developing children?
Methods:
Using the General Practice Research Database, the authors assessed the prevalence of fractures in boys with ASD diagnosed between 2 and 8 years. A cross-sectional design was used to compare the prevalence of fractures among children with ASD and age-matched controls, conditional logistic regression to explore the relative risk of having a fracture in association with diagnosed ASD.
Results:
The study population comprised 3,219 boys with a first-time diagnosis of ASD and 12,265 matched controls. ASD was associated with a significantly decreased risk of developing a fracture at any time in childhood (odds ratio [OR], 0.68, 95% confidence interval [CI], 0.59-0.77, p < .0001). The relative risk estimates were lower for the time period after ASD diagnosis (OR, 0.56, 95% CI, 0.48-0.66, p < .0001) but were not different for the time period before ASD diagnosis (OR, 0.96, 95% CI, 0.78-1.18, p = .6866). Adjusting for use of different drugs did not change the estimates.
Conclusion:
The relative risk of experiencing a fracture at any time in childhood is lower for boys with ASD compared with healthy boys.
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