Live-Birth Bias and Observed Associations between Air Pollution and Autism

Raanan Raz*, Marianthi Anna Kioumourtzoglou, Marc G. Weisskopf

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

53 Scopus citations


recent analysis found that exposure to air pollution during specific weeks of pregnancy was negatively associated with risk of autism spectrum disorder (ASD) when mutually adjusted for postnatal air-pollution exposure. In this commentary, we describe 2 possible selection-bias processes that might lead to such results, both related to live-birth bias (i.e., the inevitable restriction of the analyzed sample to live births). The first mechanism is described using a directed acyclic graph and relates to the chance of live birth being a common consequence of both exposure to air pollution and another risk factor of ASD. The second mechanism involves preferential depletion of fetuses susceptible to ASD in the higher air-pollution exposure group. We further discuss the assumptions underlying these processes and their causal structures, their plausibility, and other studies where similar phenomenamight have occurred.

Original languageAmerican English
Pages (from-to)2292-2296
Number of pages5
JournalAmerican Journal of Epidemiology
Issue number11
StatePublished - 1 Nov 2018

Bibliographical note

Publisher Copyright:
© 2018 The Author(s).


  • air pollution
  • autism spectrum disorder
  • live-birth bias


Dive into the research topics of 'Live-Birth Bias and Observed Associations between Air Pollution and Autism'. Together they form a unique fingerprint.

Cite this