This large population-based cohort study examined whether adverse perinatal outcomes are associated with an increased risk of autism spectrum disorder (ASD) in childhood. Among nearly 166,000 births, about 6.7% involved adverse perinatal outcomes, which were more frequently associated with complications such as intrauterine growth restriction, preterm birth, and cesarean delivery. During follow-up, 862 children were diagnosed with ASD. However, both unadjusted analyses and multivariable Cox regression models controlling for key confounders found no difference in the cumulative incidence or risk of ASD between children exposed and unexposed to adverse perinatal outcomes. The findings suggest that while adverse labor events are important for immediate neonatal health, they do not increase the long-term risk of ASD.

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