Abstract
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.
Similar content being viewed by others
References
Ang, E. S., Jr., Gluncic, V., Duque, A., Schafer, M., & Rakic, P. (2006). Prenatal exposure to ultrasound waves impacts neuronal migration in mice. Proceedings of the National Academy of Sciences of the United States of America, 103(34), 12903–12910.
Autism and Developmental Disabilities Monitoring Network. (2007). Surveillance Year 2002 Principal Investigators; Centers for Disease Control and Prevention. Prevalence of autism spectrum disorders-autism and developmental disabilities monitoring network, 14 sites, United States, 2002. MMWR Surveillance Summary, 56(1), 12–28.
Barnett, S. B. (2002). Routine ultrasound scanning in first trimester: What are the risks? Seminars in Ultrasound, CT and MR, 23(5), 387–391.
Bauman, M., & Kemper, T. L. (2005). Neuroanatomic observations of the brain in autism: A review and future directions. International Journal of Developmental Neuroscience, 23(2–3), 183–187.
Bellieni, C. V., Buonocore, G., Bagnoli, F., Cordelli, D. M., Gasparre, O., Calonaci, F., et al. (2005). Is an excessive number of prenatal echographies a risk for fetal growth? Early Human Development, 81(8), 689–693.
Bly, S., & Van den Hof, M. C. (2005). Obstetric ultrasound biological effects and safety. Journal of Obstetrics and Gynaecology Canada, 27(6), 572–580.
Campbell, J., Elford, R., & Brant, R. (1993). Case–control study of prenatal ultrasonography exposure in children with delayed speech. CMAJ, 149(10), 1435–1440.
Croen, L., Matevia, M., Yoshida, C., & Grether, J. (2008). Maternal Rh D status, anti-D immune globulin exposure during pregnancy, and risk of autism spectrum disorders. American Journal of Obstetrics and Gynecology, 199(3), 234.e1–234.e6. Epub 2008 Jun 13.
Dane, S., & Balci, N. (2007). Handedness, eyedness and nasal cycle in children with autism. International Journal of Developmental Neuroscience, 25(4), 223–226. Epub 2007 Mar 24.
Gillberg, C. (1983). Autistic children’s hand preferences: Results from an epidemiological study of infantile autism. Psychiatry Research, 10(1), 21–30.
Hershkovitz, R., Sheiner, E., & Mazor, M. (2002). Ultrasound in obstetrics: A review of safety. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 101(1), 15–18.
Huang, L. (1994). Ultrasound technology: The RADIUS (Routine Antenatal Diagnostic Imaging with Ultrasound) study & national policy. Journal of Clinical Engineering, 19(4), 297–309.
Keller, F., & Persico, A. (2003). The neurobiological context of autism. Molecular Neurobiology, 28(1), 1–22.
Kieler, H., Ahlsten, G., Haglund, B., Salvesen, K., & Axelsson, O. (1998a). Routine ultrasound screening in pregnancy and the children’s subsequent neurologic development. Obstetrics and Gynecology, 91(5 Pt 1), 750–756.
Kieler, H., Axelsson, O., Haglund, B., Nilsson, S., & Salvesen, K. A. (1998b). Routine ultrasound screening in pregnancy and the children’s subsequent handedness. Early Human Development, 50(2), 233–245.
Kieler, H., Cnattingius, S., Haglund, B., Palmgren, J., & Axelsson, O. (2001). Sinistrality—A side-effect of prenatal sonography: A comparative study of young men. Epidemiology, 12(6), 618–623.
Kieler, H., Haglund, B., Cnattingius, S., Palmgren, J., & Axelsson, O. (2005). Does prenatal sonography affect intellectual performance? Epidemiology, 16(3), 304–310.
Krieger, N. (1992). Overcoming the absence of socioeconomic data in medical records: Validation and application of a census-based methodology. American Journal of Public Health, 82(5), 703–710.
Lawler, C., Croen, L., Grether, J., & Van de Water, J. (2004). Identifying environmental contributions to autism: Provocative clues and false leads. Mental Retardation and Developmental Disabilities Research Reviews, 10(4), 292–302.
Lewin, J., Kohen, D., & Mathew, G. (1993). Handedness in mental handicap: Investigation into populations of Down’s Syndrome, epilepsy and autism. British Journal of Psychiatry, 163, 674–676.
Lord, C., Rutter, M., DeLovere, P. C., & Risi, S. (2000). The Autism Diagnostic Observation Schedule (ADOS). Los Angeles: Western Psychological Services.
Lord, C., Rutter, M., & Le Couteur, A. (1994). Autism diagnostic interview-revised. Journal of Autism and Developmental Disorders, 24(5), 659–685.
Lyons, E. A., Dyke, C., Toms, M., & Cheang, M. (1988). In utero exposure to diagnostic ultrasound: A 6-year follow-up. Radiology, 166(3), 687–690.
Marinac-Dabic, D., Krulewitch, C. J., & Moore, R. M., Jr. (2002). The safety of prenatal ultrasound exposure in human studies. Epidemiology, 13(3 Suppl), S19–S22.
Mole, R. (1986). Possible hazards of imaging and Doppler ultrasound in obstetrics. Birth, 13(1), 29–38.
Muhle, R., Trentacoste, S. V., & Rapin, I. (2004). The genetics of autism. Pediatrics, 113(5), e472–e486.
Newnham, J. P., Doherty, D. A., Kendall, G. E., Zubrick, S. R., Landau, L. L., & Stanley, F. J. (2004). Effects of repeated prenatal ultrasound examinations on childhood outcome up to 8 years of age: Follow-up of a randomised controlled trial. Lancet, 364(9450), 2038–2044.
Newnham, J. P., Evans, S. F., Michael, C. A., Stanley, F. J., & Landau, L. I. (1993). Effects of frequent ultrasound during pregnancy: A randomised controlled trial. Lancet, 342(8876), 887–891.
Newschaffer, C. J., Fallin, D., & Lee, N. L. (2002). Heritable and nonheritable risk factors for autism spectrum disorders. Epidemiologic Reviews, 24(2), 137–153.
Rados, C. (2004). FDA cautions against ultrasounds ‘keepsake’ images. FDA Consumer, 38(1), 12–16.
Rodgers C. (2006). Questions about prenatal ultrasound and the alarming increase in autism. Midwifery Today with International Midwife, (80), 16–19, 66–17.
Rodier, P. M. (2004). Environmental causes of central nervous system maldevelopment. Pediatrics, 113(4 suppl), 1076–1083.
Salvesen, K. A. (2007). Epidemiological prenatal ultrasound studies. Progress in Biophysics and Molecular Biology, 93(1–3), 295–300. Epub 2006 Aug 22.
Salvesen, K. A., Vatten, L. J., Eik-Nes, S. H., Hugdahl, K., & Bakketeig, L. S. (1993). Routine ultrasonography in utero and subsequent handedness and neurological development. BMJ, 307(6897), 159–164.
Scheidt, P. C., Stanley, F., & Bryla, D. A. (1978). One-year follow-up of infants exposed to ultrasound in utero. American Journal of Obstetrics and Gynecology, 131(7), 743–748.
Stark, C. R., Orleans, M., Haverkamp, A. D., & Murphy, J. (1984). Short- and long-term risks after exposure to diagnostic ultrasound in utero. Obstetrics and Gynecology, 63(2), 194–200.
Acknowledgments
We wish to express appreciation to Kaht Dorward, MD, and Linda Copeland, MD, practicing physicians within Kaiser Permanente of Northern California, for providing clinical consultation and to Meredith Anderson, MA, and Daniel Smith, DrPH, colleagues within California Department of Public Health, for statistical consultation and for careful review of the manuscript. Any errors in calculation or interpretation of data are those of the authors. This study was funded by grants from the Centers for Disease Control and Prevention, (U10/CCU920392), the Kaiser Foundation Research Institute, and Autism Speaks, and by the California Department of Public Health.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Grether, J.K., Li, S.X., Yoshida, C.K. et al. Antenatal Ultrasound and Risk of Autism Spectrum Disorders. J Autism Dev Disord 40, 238–245 (2010). https://doi.org/10.1007/s10803-009-0859-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10803-009-0859-4