In utero beta 2 adrenergic agonist exposure and adverse neurophysiologic and behavioral outcomes

Does treatment of premature labor with terbutaline increase the risk of autism spectrum disorders?

“…Thus, it is reasonable to ask whether there is evidence that medications, such as terbutaline, to which pregnant women may be exposed increase the risk for an ASD outcome in the offspring. Our argument is not with the intent but with the quality of the evidence presented in the review by Witter et al, 1 which we now describe.…”

“…1 However, it is important to note that the studies that are cited come almost exclusively from 1 research group and use the same dose at the same stage of development for the same number of repeated doses. If there is any error in the dose or timing or duration of exposure that was chosen to mimic terbutaline as a tocolytic therapy, it is shared by all the articles that were cited.…”

“…We conducted an examination of the human and animal studies that have been used to support this hypothesis in a recent review, 1 and we have reached a different conclusion. We find no support for the hypothesis that the use of terbutaline as a tocolytic agent is associated with the subsequent development of ASDs.…”

Autism Spectrum Disorders are not linked to β-2-Adrenergic Receptor Agonists Treatment for Preterm Labor/Asthma

“…Witter et al [14] performed a clinical literature review regarding preterm labor treatment stimulated by a basic science hypothesis that exposure to β-2AR drugs led to brain lesions in rats [15]. In an invited response by the American Journal of Obstetrics and Gynecology, the noted teratologist, Brent et al [16] debunked the hypothesis that β-2AR was in anyway related to ASD.…”

“…In an invited response by the American Journal of Obstetrics and Gynecology, the noted teratologist, Brent et al [16] debunked the hypothesis that β-2AR was in anyway related to ASD. Furthermore, in a response to a letter to the editor by Brent et al noted that in the original article [14] much of the evidence claimed by Witter et al "was not present in the references cited or conflicted with the actual results reported in their literature" [17]. They also identified other "egregious omissions" in the Witter et al [14] paper such as failure to note that preterm birth itself is strongly associated with an increased risk for ASD and that drug exposures already known to be risk factors for ASD, have their critical periods during the first trimester making the hypothesis that β-2AR used in the 2 nd or 3 rd trimester would lead to ASD very unlikely.…”