Autism and high levels of hormones in the womb

The media has shown a lot of interest in a recently published study that examined levels of hormones in prenatal amniotic fluid, and related this to subsequent diagnoses of autism. In general, the media coverage has been fairly accurate in relation to describing the study methods and findings, and in quoting the researchers who published the study. The topic is a highly sensitive one, and highlights the importance of a carefully worded press release to ensure that the implications of a study are not stretched beyond the specific findings shown. The media do not seem to have over stretched the implications, which could have been of a highly controversial nature had they chosen to ignore the researchers carefully worded statements.

The study was lead by researchers at the Universities of Cambridge and Copenhagen. An excellent lay summary of the study has been provided by the NHS Behind the Headlines team so there is no need to provide a detailed summary here. In brief, the study measured sex hormone levels in the amniotic fluid of more than 300 boys. Hormone levels were found to be higher in boys who went on to develop autism.

How did the media handle the coverage?

Several popular media outlets covered the research findings: the BBC, Guardian, Daily Mail,  and Independent. The media handled coverage of the study very carefully, particularly in relation to referring to the highly sensitive topic of prenatal testing. The researchers very clearly stated in the press release published on the study that the results should not be taken “as a promising prenatal screening test”.  The researchers further explained that “there is considerable overlap between the groups and our findings showed differences found at an average group level, rather than at the level of accurately predicting diagnosis for individuals”. What this means is that while a relationship was found between high levels of hormones and an autism diagnosis, not all of the children in either group showed this relationship. So only a proportion of the sample who went on to develop autism showed high levels of these hormones. We previously outlined the findings of another study with children with autism in a Research the Headlines post, where the findings reflected the group as a whole but did not necessarily reflect all individuals in the sample. All of the media coverage on the current autism and hormones study mentioned above referred to the researcher’s statement that the results do not have implications for the development of prenatal testing. This highlights the importance of a carefully worded press release where sensitive inaccurate implications could be drawn.

The media were also careful to avoid a ‘treatment’ implication that could have been suggested by the findings, but which again the researchers were careful to clarify in the press release. Many of them directly quoted the statement from the lead Cambridge researcher (Prof. Simon Baron-Cohen) that “these results should not be taken as a reason to jump to steroid hormone blockers as a treatment as this could have unwanted side effects and may have little to no effect in changing the potentially permanent effects that fetal steroid hormones exert during the early foundational stages of brain development.” Again thankfully the media paid careful attention to this statement and all included some reference to it.

The BBC and Independent incorrectly referred to the study as showing that ‘male hormones’ were linked to autism. This mistake hasn’t occurred though with an agenda to be sensationalist but is simply a misinterpretation of the findings. On a very positive note, most of the media coverage sought expert opinions on the study and included quotes from relevant experts (e.g. Richard Sharpe at the MRC Centre for Reproductive Health, Edinburgh) and referred to the journal the study was published in. Later this month we will add a post to our  How to “Research the Headlines” series on the importance of including expert statements. Back to the autism and hormones coverage though – all in all very nice reporting!

Baron-Cohen, S., Auyeung, B., Nørgaard-Pedersen, B., Hougaard, D. M., Abdallah, M. W., Melgaard, L., Cohen, A. S., Chakrabarti, B., Ruta, L., Lombardo, M. V. (2014). Elevated fetal steroidogenic activity in autism. Molecular Psychiatry. DOI: 10.1038/mp.2014.48