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Comment & Response
February 15, 2021

Methodologic Concerns With Concluding a Link Between Epidural and Autism Spectrum Disorder—Reply

Author Affiliations
  • 1Department of Anesthesiology, Kaiser Permanente Baldwin Park Medical Center, Baldwin Park, California
  • 2Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
JAMA Pediatr. 2021;175(5):537-538. doi:10.1001/jamapediatrics.2020.6695
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    1 Comment for this article
    Not an argument
    Brooke Orosz |
    "We are concerned about the assertions about biologic plausibility because that depends on the current state of knowledge. The lack of plausibility today does not preclude biological plausibility tomorrow; rather, this newly discovered association provides impetus for more biologic research."

    This isn't an argument. While we don't know everything about epidural anesthesia and the newborn brain, we do know quite a bit, and based on that knowledge, it's pretty implausible. While this could change, making claims like this on the basis of plausibility that might be discovered later is like buying a fancy car on the assumption that
    you might win the lottery later.

    Yes, it's possible that the association between epidural anesthesia and autism is real, but the other explanations are so much more plausible. And the authors do have an obligation to consider the very real harm that publicizing this study will do.

    Stop spending all these resources looking for the cause of autism, especially using such weak evidence. Until basic neuro science advances further, we aren't going to find it. Devote those resources to helping to make life easier for people with autism.