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Haloperidol-related dyskinesias and pre- and perinatal complications in autistic children
J L Armenteros1, P B Adams, M Campbell
1Department of Psychiatry, New York University Medical Center, New York, USA.
Insights
This study suggests pre- and perinatal complications may increase the risk of developing tardive dyskinesia (TD) and withdrawal dyskinesias (WD) in children with autism. Higher obstetrical complication scores were linked to TD/WD development.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Pharmacology
Background:
- Central nervous system (CNS) dysfunction is hypothesized to link pre- and perinatal complications with tardive dyskinesia (TD) and withdrawal dyskinesias (WD).
- Autism Spectrum Disorder (ASD) is a neurodevelopmental condition often managed with psychotropic medications, increasing the relevance of TD/WD research in this population.
Purpose of the Study:
- To investigate the association between pre- and perinatal complications and the development of TD/WD in children with autism.
- To identify specific obstetrical factors that may predict TD/WD risk in this cohort.
Main Methods:
- A prospective study assessed 118 children with autism receiving haloperidol.
- The Rochester Research Obstetrical Scale (ROS) was used to quantify pre- and perinatal complications.
- Statistical analyses compared ROS scores and specific delivery factors between children who developed TD/WD and those who did not.
Main Results:
- Children who developed TD/WD had significantly higher mean total ROS scores and ROS Delivery Scale scores.
- Anesthesia during delivery was more frequent in children who developed TD/WD (62.5%) compared to those who did not (38.5%).
- Specific complications like non-vertex presentation (in females) and short labor (in males) were associated with TD/WD.
Conclusions:
- Pre- and perinatal complications appear to be associated with the development of TD/WD in children with autism.
- Obstetrical factors, including delivery method and labor duration, may influence TD/WD risk.
- Further research is warranted to elucidate the mechanisms linking these complications to dyskinesias in pediatric populations.
Abstract:
It has been hypothesized that an association exists between pre- and perinatal complications, central nervous system (CNS) dysfunction, and the development of tardive (TD) and withdrawal dyskinesias (WD). We assessed the relationship between pre- and perinatal complications and TD/WD in a sample of 118 children with autism who participated in an ongoing long-term prospective study of the efficacy and safety of haloperidol. The mean total Rochester Research Obstetrical Scale (ROS) score was significantly higher for children who developed TD/WD compared to those who did not (p = .007) as was the mean score of the ROS Delivery Scale (p = .002). Anesthesia during delivery was more frequent in children who developed TD/WD (25 of 40, 62.5%) than in those who did not (30 of 78, 38.5%) (p = .019). The ROS Not Vertex Presentation item and TD/WD were associated only in females (p = .019). Six of 7 males with short labor developed TD/WD (p = .007). ROS scores did not differ significantly as a function of gender or socio-economic status (SES). Pre- and perinatal complications appear to be related to the development of TD/WD in this sample of children.