American Journal of Epidemiology Copyright © 2005 by the Johns Hopkins Bloomberg School of Public Health All rights reserved
ORIGINAL CONTRIBUTIONS |
Invited Commentary: Risk Factors for AutismPerinatal Factors, Parental Psychiatric History, and Socioeconomic Status
1 Center for Autism and Developmental Disabilities Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
2 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Correspondence to Dr. Craig J. Newschaffer, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Room E6030, Baltimore, MD 21205 (e-mail: cnewscha@jhsph.edu).
Received for publication October 8, 2004. Accepted for publication January 20, 2005.
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The paper by Larsson et al. (1
) in this issue of the Journal adds to an accumulating body of evidence from relatively large, population-based observational studies (2
, 3
) suggesting that pregnancy complications and adverse birth outcomes are associated with subsequent risk of autism. As the struggle to understand the etiology of this devastating neurodevelopmental disorder continues, this growing literature offers promising opportunities for future research.
In their discussion, Larsson et al. (1
) touch on the challenge of determining whether an observed association between obstetric suboptimality and autism risk reflects an independent causal contribution or whether it arises merely as a by-product of genetic susceptibility. Should the former be true, it implies that adverse pre- and perinatal events
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