SDMS takes issue with ultrasound autism study

The Society of Diagnostic Medical Sonography (SDMS) is expressing concern that a recent study linking first-trimester ultrasound with more severe autism symptoms may lead pregnant women to skip or delay a medically necessary examination.

The study, published September 1 in Autism Research, found an association between first-trimester ultrasound and greater severity of autism symptoms in fetuses with a genetic predisposition to autism spectrum disorder.

However, the SDMS noted that most ultrasound scans are not performed during the first trimester of pregnancy. The society shared the researchers' concern about the proliferation of nonmedical entertainment ultrasounds, but it said the study's design raises serious questions about the conclusions reached by the authors.

In the SDMS statement, Kevin Evans, PhD, of Ohio State University's Division of Radiologic Sciences and Therapy, said this type of research is very difficult to conduct and its design is limited by threats to internal and external validity.

"These factors are compounded because of a lack of randomization of the subjects and the semistructured interview process used in this study," Evans said. "To truly control for extraneous variables, the research would require a preclinical study that was randomized and highly controlled."

As a result, Evans said he did not think the study was strong enough to support the authors' assertions and statements.

"More properly designed research is needed to prove or disprove any link between ultrasound and autism," said Evans, who is also the incoming editor of the society's Journal of Diagnostic Medical Sonography.

Based on the available research and the millions of sonographic examinations performed each year, the SMDS believes that sonography is safe and beneficial when performed for a medical purpose and by a person with appropriate education, training, experience, and certification, said SDMS President Sheryl Goss.

"We encourage pregnant women to talk with their physician if they have questions or concerns," Goss said. "However, they should not avoid having medically necessary examinations using ultrasound during pregnancy based on this limited study."

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