This article is a US government work and, as such, is in the public domain in the United States of America.
Relationships between multiple births and autism spectrum disorders, cerebral palsy, and intellectual disabilities: autism and developmental disabilities monitoring (ADDM) network—2002 surveillance year†
Article first published online: 29 OCT 2008
Published 2008 International Society for Autism Research, Wiley Periodicals, Inc.
Volume 1, Issue 5, pages 266–274, October 2008
How to Cite
Van Naarden Braun, K., Schieve, L., Daniels, J., Durkin, M., Giarelli, E., Kirby, R. S., Lee, L.-C., Newschaffer, C., Nicholas, J. and Pinto-Martin, J. (2008), Relationships between multiple births and autism spectrum disorders, cerebral palsy, and intellectual disabilities: autism and developmental disabilities monitoring (ADDM) network—2002 surveillance year. Autism Res, 1: 266–274. doi: 10.1002/aur.41
- Issue published online: 28 NOV 2008
- Article first published online: 29 OCT 2008
- Manuscript Accepted: 15 SEP 2008
- Manuscript Revised: 14 AUG 2008
- Manuscript Received: 9 MAY 2008
- developmental disabilities;
- multiple births;
- autism spectrum disorders;
- intellectual disabilities;
- cerebral palsy
Since the 1970s, the prevalence of multiple births (MBs) in the United States has increased significantly. This has been attributed, in large part, to iatrogenic MBs resulting from infertility treatments that include ovulation stimulation. A past study has indicated that children from MBs have an increased prevalence of cerebral palsy (CP). Other studies also have suggested an association between MBs and intellectual disabilities (ID) and autism spectrum disorders (ASDs); however, results have been inconsistent. From the Autism and Developmental Disabilities Monitoring (ADDM) Network, a surveillance project among several US populations, we obtained MB estimates among children born in 1994 and classified by 8 years of age as having: an ASD (n=1,626 total children from 11 sites; 50 born as part of an MB); CP (n=302 total children from 3 sites; 25 born as part of an MB); or ID (n=1,195 total children from 3 sites; 45 born as part of an MB). All three MB estimates were notably higher than age-adjusted expected estimates of naturally conceived MBs derived from 1971 US natality data. However, when MB estimates from the ADDM Network were compared with expected MB estimates derived from 1994 natality data for the states corresponding to the relevant ADDM Network sites, we observed no association with ASDs (observed/expected=1.08 [0.78–1.38]), a moderate, but not statistically significant association with ID (observed/expected=1.34 [0.95–1.73]), and a strong association with CP (observed/expected=2.96 [1.80–4.12]). Further investigation of specific types of MBs (natural vs. iatrogenic) is warranted.