Simon, EN. Conrad Simon Memorial Research Initiative,,
11 Hayes Avenue, Lexington MA 02421-3521, USA

Background: Delay in initiating respiration at birth has been reported in children who later
developed autism.

Objectives: Compare statistics on respiratory depression at birth with those for increased
prevalence of autism.

Methods: Review of the literature on (1) the effects of oxygen insufficiency at birth, (2) traditional
versus current obstetric practice, (3) transition from fetal to neonatal respiration, (4) statistics
on delayed pulmonary respiration at birth, and (5) reports of perinatal complications associated
with autism.

Results: (1) Experiments on asphyxia at birth in monkeys demonstrated that a brief lapse in
respiration at birth damages nuclei in the brainstem, most prominently in the auditory pathway.
(2) Traditional textbooks taught that the umbilical cord should not be cut until pulmonary
respiration was established. The current protocol is to clamp the cord within 30 seconds after
birth. (3) Transition from fetal to neonatal respiration requires filling of the capillaries
surrounding the alveoli before carbon dioxide can be exchanged for oxygen. This may take
several minutes. (4) Most infants breathe within 30 seconds of birth, but in 5.2 to 6.2 per 1000
births, delay in establishing respiration at birth has become a frightening dilemma. (5) Perinatal
complications are among the many medical problems associated with autism, and the statistics
for respiratory depression at birth are similar to those reported in recent epidemiological studies
of autism prevalence.

Conclusion: Investigations of increased prevalence of autism must include review of current
childbirth practices and the effects of asphyxia at birth on the auditory system of the brain.

Sponsor: Conrad Simon Memorial Research Initiative
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