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Association between Beta-Sympathomimetic Tocolysis and Risk of Autistic Spectrum Disorders, Behavioural and
Mengühan Araz Altay1, Işık Görker2, Rakhshanda Aslanova3
1Department of Child and Adolescent Psychiatry, Edirne Sultan 1. Murat State Hospital, Edirne, Turkey.
Insights
Maternal use of beta-mimetic tocolytic therapy during pregnancy did not increase the risk of autistic spectrum disorders (ASD) or developmental issues in toddlers. However, early tocolytic treatment in preterm infants was linked to poorer outcomes.
Area of Science:
- Obstetrics and Gynecology
- Developmental Pediatrics
- Neonatology
Background:
- Beta-mimetic tocolytic therapy is used to prevent preterm birth.
- Concerns exist regarding potential neurodevelopmental effects of in utero drug exposure.
- Autistic spectrum disorders (ASD) and behavioral problems are significant developmental concerns.
Purpose of the Study:
- To determine if maternal beta-mimetic tocolytic therapy increases the risk of ASD.
- To investigate the association between tocolytic exposure and behavioral/developmental outcomes in toddlers.
Main Methods:
- Prospective case-control study of 90 toddlers (1.5-3 years old).
- Cases (n=46) had maternal tocolytic exposure; controls (n=44) did not.
- Evaluations included BITSEA, M-CHAT, and DDST for social, emotional, autism, and developmental assessments.
Main Results:
- No increased risk of ASD or poorer behavioral/developmental outcomes in tocolytic-exposed toddlers (term and preterm).
- In preterm infants, earlier tocolytic treatment start correlated with lower Competencies Scale scores and higher Problems Scale scores.
- Preterm premature rupture of membranes was linked to higher ASD risk in the untreated group.
Conclusions:
- In utero exposure to beta-mimetic tocolytics was not associated with increased risk of autism or developmental disorders.
- Early tocolytic treatment initiation in preterm infants may warrant further investigation for potential impacts on developmental trajectories.
Aim:
To investigate whether maternal intravenous beta-mimetic tocolytic therapy increases the risk of autistic spectrum disorders (ASD) and poorer behavioural and developmental outcomes.
Method:
Our study is a prospective case-control study among 90 children between 1.5 and three years old. Cases (n = 46) were toddlers with betamimetic tocolytic exposure; control group toddlers (n = 44) were tocolytic untreated. Treated and untreated groups were also divided into subgroups: term and preterm delivered. The gestational age of tocolytic treatment start, the dose and duration of exposure in hours were obtained from obstetric medical records. The Brief Infant-Toddler Social and Emotional Assessment (BITSEA), the Modified Checklist for Autism in Toddlers (M-CHAT) and the Denver Developmental Screening Test (DDST) tests were applied for evaluation of social, emotional problems, autism and developmental disorders.
Results:
Term and preterm born toddlers treated tocolytically in utero didn't demonstrate a higher risk of autistic disorders or poorer behavioural and developmental results than controls. In the preterm group, the earliest start of tocolytic treatment was correlated with toddlers lower score of the Competencies Scale (p = 0.009) and a higher score of the Problems Scale (p = 0.048). Also, we concluded that preterm membrane rupture was associated with higher ASD risk in the untreated group (p = 0.043).
Conclusion:
Exposure to betamimetics during pregnancy was not associated with an increased risk of autism, behavioural and developmental disorders.
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