Antenatal Ultrasound and Risk of Autism Spectrum Disorders

Environmental Health Investigations Branch, California Department of Public Health, Richmond, CA 94804, USA.
Journal of Autism and Developmental Disorders (Impact Factor: 3.06). 10/2009; 40(2):238-45. DOI: 10.1007/s10803-009-0859-4
Source: PubMed


We evaluated antenatal ultrasound (U/S) exposure as a risk factor for autism spectrum disorders (ASD), comparing affected singleton children and control children born 1995-1999 and enrolled in the Kaiser Permanente health care system. Among children with ASD (n = 362) and controls (n = 393), 13% had no antenatal exposure to U/S examinations; case-control differences in number of exposures during the entire gestation or by trimester were small and not statistically significant. In analyses adjusted for covariates, cases were generally similar to controls with regard to the number of U/S scans throughout gestation and during each trimester. This study indicates that antenatal U/S is unlikely to increase the risk of ASD, although studies examining ASD subgroups remain to be conducted.

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Available from: Sherian X Li, Jan 16, 2015
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    • "Another study [Stalberg et al., 2009] correlated the number of dUS exams during the second trimester to school performance, finding a trend (without statistical significance) toward lower mean school grades for boys but not for girls. Two other studies that sought to directly assay at the population level the likelihood of ASD and proxies for dose of dUS dose failed to find a meaningful correlation [Grether, Li, Yoshida, & Croen, 2010; Stoch et al., 2012]. Because of the in vivo results and the increase in power of dUS since FDA standards were set [Gibbs et al., 2009], there remain concerns about the overall safety of dUS and its potential link to increased risk of ASD [Abramowicz, 2012; ter Haar et al., 2013; Williams & Casanova, 2010, 2013]. "
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    ABSTRACT: Clinical use of diagnostic ultrasound imaging during pregnancy has a long history of safety and diagnostic utility, as supported by numerous human case reports and epidemiological studies. However, there exist in vivo studies linking large but clinically relevant doses of ultrasound applied to mouse fetuses in utero to altered learning, memory, and neuroanatomy of those mice. Also, there exists a well-documented significant increase in the likelihood of non-right-handedness in boys exposed to diagnostic ultrasound in utero, potentially relevant given the increased prevalence of autism in males, and reports of excess non-right-handedness in this population. Motivated by these observations, we applied 30 minutes of diagnostic ultrasound to pregnant mice at embryonic day 14.5 and assayed the social behavior of their male pups 3 weeks after their birth. The ultrasound-exposed pups were significantly (P < 0.01) less interested in social interaction than sham-exposed pups in a three-chamber sociability test. In addition, they demonstrated significantly (P < 0.05) more activity relative to the sham-exposed pups, but only in the presence of an unfamiliar mouse. These results suggest that fetal exposure to diagnostic ultrasound applied in utero can alter typical social behaviors in young mice that may be relevant for autism. There exist meaningful differences between the exposure of diagnostic ultrasound to mice versus humans that require further exploration before this work can usefully inform clinical practice. Future work should address these differences as well as clarify the extent, mechanisms, and functional effects of diagnostic ultrasound's interaction with the developing brain. Autism Res 2013, ●●: ●●-●●. © 2013 International Society for Autism Research, Wiley Periodicals, Inc.
    Full-text · Article · Jun 2014 · Autism Research
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    • "91). Just as Ziskin and Petitti have suggested, such assumptions are still present today which continue to falsely impress upon the science that safety studies have been adequate and thorough (for example, see [16]). Research into transient cavitational and thermal effectors have been considerable, and provided A. "
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    ABSTRACT: Science has shown that risk of cavitation and hyperthermia following prenatal ultrasound exposure is relatively negligible provided intensity, frequency, duration of exposure, and total numbers of exposures are safely limited. However, noncavitational mechanisms have been poorly studied and occur within what are currently considered “safe” levels of exposure. To date, the teratogenic capacity of noncavitational effectors are largely unknown, although studies have shown that different forms of ultrasound-induced hydraulic forces and pressures can alter membrane fluidity, proliferation, and expression of inflammatory and repair markers. Loose regulations, poor end user training, and unreliable ultrasound equipment may also increase the likelihood of cavitation and hyperthermia during prenatal exposure with prolonged durations and increased intensities. The literature suggests a need for tighter regulations on the use of ultrasound and further studies into its teratogenicity.
    Full-text · Article · Mar 2013
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    • "ASD cannot be reliably diagnosed until after birth, and thus prospective investigations of prenatal life have been rare. One study retrospectively compared the frequency and timing of prenatal ultrasound scans among children later diagnosed with ASD and matched typically developing controls, reporting largely null findings (Grether et al. 2010). However, information on the type of ultrasonography the women received could not be gleaned from medical records in approximately 25 % of scans, and therefore only limited conclusions can be drawn from these data. "
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    ABSTRACT: An existing randomised controlled trial was used to investigate whether multiple ultrasound scans may be associated with the autism phenotype. From 2,834 single pregnancies, 1,415 were selected at random to receive ultrasound imaging and continuous wave Doppler flow studies at five points throughout pregnancy (Intensive) and 1,419 to receive a single imaging scan at 18 weeks (Regular), with further scans only as indicated on clinical grounds. There was no significant difference in the rate of Autism Spectrum Disorder between the Regular (9/1,125, 0.8 %) and Intensive (7/1,167, 0.6 %) groups, nor a difference between groups in the level of autistic-like traits in early adulthood. There is no clear link between the frequency and timing of prenatal ultrasound scans and the autism phenotype.
    Full-text · Article · Mar 2012 · Journal of Autism and Developmental Disorders
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