Several researchers not involved in the study cautioned that factors other than pitocin are probably more likely to account for the study's findings.
For example, autism risk could have been elevated by certain complications that cause doctors to administer pitocin. In that scenario, the complication – not induction or augmentation itself – could be the factor contributing to higher risk of a cognitive disorder. When a woman's water breaks earlier than it should, for instance, doctors often decide to induce to minimize the risk of a dangerous infection. But even with induction, mild infections are not uncommon in such situations, and they could potentially trigger brain changes that leave the baby more susceptible to autism, said Jennifer Bailit, an obstetrician at Metrohealth Medical Center in Cleveland.
Alternatively, the seemingly higher rate of autism in children born by induction could be a statistical mirage. Bailit noted that mothers in the study who'd graduated college were one-third more likely to have children diagnosed with autism than were mothers who'd completed high school but not attended college. That's probably not because either group actually experiences higher rates of autism, but rather because kids who develop autism are more likely to receive a doctor's diagnosis if their parents are well educated. Interestingly, Bailit noted, well-educated women are also more likely to undergo induction. That alone, she suggested, could account for the link found by the Duke team.
Other researchers emphasized that inductions, while often medically necessary, should be avoided whenever they're unnecessary. For many years, so-called elective inductions were common in some hospitals. Sometimes doctors induced women before the fetus had fully matured, leading to avoidable health problems in the newborn. Medical experts and hospital leaders have cracked down on that dangerous practice in recent years, and now strongly discourage doctors and patients from electing to induce unless there's a strong medical reason to do so or the fetus is at least 39 weeks old.
Among women whose pregnancies haven't yet reached 39 weeks, said obstetrician/gynecologist Susan C. Mann of Beth Israel Deaconness Medical Center in Boston, "most hospitals these days since about 2011 have a hard stop on medically [unnecessary] inductions."
[Read: Signs Your Child Could Have Autism.]