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Periconceptional Hormonal Contraception Use and Autism Spectrum Disorder in the Study to Explore Early Development.

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Area of Science:

  • Reproductive Health
  • Neurodevelopmental Disorders
  • Perinatal Epidemiology

Background:

  • Previous research suggests a link between periconceptional hormone exposure and autism spectrum disorder (ASD).
  • Hormonal contraception, containing synthetic oestrogen and progesterone, is widely used.
  • Potential fetal exposure during pregnancy due to hormonal contraception use is a concern, with unknown consequences.

Purpose of the Study:

  • To investigate the association between periconceptional hormonal contraception use and the development of ASD in offspring.
  • To differentiate between hormonal contraception use prior to and during pregnancy in relation to ASD risk.

Main Methods:

  • Analysis of data from the Study to Explore Early Development (SEED), a US population-based case-control study (2007-2020).
  • Inclusion of children aged 2.5-5 years with confirmed ASD diagnoses and controls.
  • Assessment of hormonal contraception use via structured interviews, with logistic regression adjusting for covariates.

Main Results:

  • A suggestive association was observed between hormonal contraception use during pregnancy and ASD (adjusted odds ratio [aOR] 1.38, 95% CI 0.93-2.05).
  • No significant association was found between hormonal contraception use prior to pregnancy and ASD (aOR 1.02, 95% CI 0.84-1.25).
  • Hormonal contraception use during pregnancy was reported by 2.3% of participants, while 9.9% discontinued use before pregnancy.

Conclusions:

  • Discontinuation of hormonal contraception before conception is not associated with an increased risk of ASD.
  • The study highlights potential imprecision in results due to low prevalence, recall bias, and unmeasured confounding.
  • Further research is needed to clarify the relationship between hormonal contraception use during pregnancy and ASD development.