Newborn circumcision not linked to autism in large cohort study

Clinical takeaway: When discussing newborn circumcision, clinicians can explain that this large prospective cohort found no evidence of an increased risk of autism or autism-related traits.

Concerns about a possible association between newborn male circumcision and autism have been raised, although previous evidence has been limited and inconsistent. A large cohort study now adds reassuring evidence that no such association was observed.

Researchers analyzed data from 2,771 male singleton children enrolled across 14 sites in the Environmental Influences on Child Health Outcomes (ECHO) Consortium. Overall, 66% underwent neonatal circumcision within 28 days of birth, and 7% were later diagnosed with autism spectrum disorder (ASD).

After accounting for demographic, perinatal, and clinical factors, neonatal circumcision was not associated with ASD diagnosis. The findings were consistent across subgroup analyses, including by geographic region, preterm birth, and neonatal intensive care unit admission.

The investigators also found no association between neonatal circumcision and autism-related traits or behaviors measured using two validated assessment tools: the Social Responsiveness Scale (SRS-2) and the Child Behavior Checklist (CBCL). Results remained unchanged regardless of whether outcomes were analyzed as continuous scores or clinically significant thresholds.

For clinicians, these findings provide evidence to support counseling families that decisions about newborn circumcision do not appear to influence a child's risk of autism. The authors note that the prospective design, detailed clinical data, and use of validated autism measures strengthen confidence in the findings compared with earlier studies.

"This cohort study yielded no evidence that neonatal medical male circumcision was associated with autism spectrum disorder risk, whether assessed by parent report of medical professional diagnosis or validated instruments measuring autism-related traits and behavior," the study authors concluded.

Source: McGrath M, et al. (2026 Aug 3) JAMA Pediatr. Neonatal Medical Male Circumcision and Child Autism Diagnosis