Journal of American Medical Association study: Folic acid may reduce autism risk

12 Feb

Moi has written several blog posts about autism. In University of Connecticut study: Some children with autism may be ‘cured’ with intense early therapy:

In order for children with autism to reach their full potential there must be early diagnosis and treatment.

Autism Speaks reports about a University of Connecticut study in the post, Study Confirms “Optimal Outcomes”:

Some children diagnosed with autism in early childhood reach “optimal outcomes” with levels of function similar to their typical peers. The findings appear today in the Journal of Child Psychology and Psychiatry.

Although the diagnosis of autism is not usually lost over time, the findings suggest that there is a very wide range of possible outcomes,” says Thomas Insel, M.D., director of the National Institutes of Mental Health (NIMH). “For an individual child, the outcome may be knowable only with time and after some years of intervention.”

This week’s report is the first in a series of autism studies on optimal outcomes, sponsored by the NIMH. They follow up on earlier reports that a small group of children appear to “lose” their autism diagnosis over time. Some experts have questioned the accuracy of these children’s initial diagnoses. Others argued that simply being able to function in a mainstream classroom doesn’t mean that these children don’t quietly struggle with autism-related disabilities. http://www.autismspeaks.org/science/science-news/study-confirms-%E2%80%9Coptimal-outcomes%E2%80%9D

https://drwilda.com/2013/01/19/university-of-connecticut-study-some-children-with-autism-may-be-cured-with-intense-early-therapy/

The Journal of the American Medical Association (JAMA) is reporting in a new study that folic acid use during pregnancy may reduce autism risk.

Steven Reinberg, Health Day Reporter for WebMD reports in Folic Acid in Pregnancy May Lower Autism Risk:

A new study suggests that women who start taking folic acid supplements either before or early in their pregnancy may reduce their child’s risk of developing autism.

“The study does not prove that folic acid supplements can prevent childhood autism. But it does provide an indication that folic acid might be preventive,” said study lead author Dr. Pal Suren, from the division of epidemiology at the Norwegian Institute of Public Health in Oslo.

“The findings also provide a rationale for further investigations of possible causes, as well as investigations of whether folic acid is associated with a reduced risk of other brain disorders in children,” he said.

Taking folic acid supplements during pregnancy is already known to prevent birth defects such as spina bifida, which affects the spine, and anencephaly, which causes part of the brain to be missing.

Alycia Halladay, senior director of environmental and clinical sciences at Autism Speaks, said that “parents always wonder what they can do to reduce the risk [of autism], and this [folic acid] is a very inexpensive item that mothers can do both before pregnancy and very early in their pregnancy.”

As to why folic acid may be beneficial, Halladay speculated that the nutrient might blunt a genetic risk for autism or boost other processes during pregnancy that are protective.

Another expert, Dr. Roberto Tuchman, director of the Autism and Neurodevelopment Program at Miami Children’s Hospital’s Dan Marino Center, said, “This study suggests that in some kids autism spectrum disorders may be preventable. As a clinician who works with autism spectrum disorders it is exciting that we can look at potentially preventable factors in autism. This is really encouraging.”

Still, Tuchman cautioned that the study findings are very preliminary, and it isn’t possible to tell which autism spectrum disorders, if any, folic acid may prevent. http://www.webmd.com/brain/autism/news/20130212/folic-acid-in-pregnancy-may-lower-autism-risk

Citation:

February 13, 2013, Vol 309, No. 6 >

Original Contribution | February 13, 2013

Association Between Maternal Use of Folic Acid Supplements and Risk of Autism Spectrum Disorders in Children FREE

Pål Surén, MD, MPH; Christine Roth, MSc; Michaeline Bresnahan, PhD; Margaretha Haugen, PhD; Mady Hornig, MD; Deborah Hirtz, MD; Kari Kveim Lie, MD; W. Ian Lipkin, MD; Per Magnus, MD, PhD; Ted Reichborn-Kjennerud, MD, PhD; Synnve Schjølberg, MSc; George Davey Smith, MD, DSc; Anne-Siri Øyen, PhD; Ezra Susser, MD, DrPH; Camilla Stoltenberg, MD, PhD

JAMA. 2013;309(6):570-577. doi:10.1001/jama.2012.155925.

Text Size: A A A

Article

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References

Importance  Prenatal folic acid supplements reduce the risk of neural tube defects in children, but it has not been determined whether they protect against other neurodevelopmental disorders.

Objective  To examine the association between maternal use of prenatal folic acid supplements and subsequent risk of autism spectrum disorders (ASDs) (autistic disorder, Asperger syndrome, pervasive developmental disorder–not otherwise specified [PDD-NOS]) in children.

Design, Setting, and Patients  The study sample of 85 176 children was derived from the population-based, prospective Norwegian Mother and Child Cohort Study (MoBa). The children were born in 2002-2008; by the end of follow-up on March 31, 2012, the age range was 3.3 through 10.2 years (mean, 6.4 years). The exposure of primary interest was use of folic acid from 4 weeks before to 8 weeks after the start of pregnancy, defined as the first day of the last menstrual period before conception. Relative risks of ASDs were estimated by odds ratios (ORs) with 95% CIs in a logistic regression analysis. Analyses were adjusted for maternal education level, year of birth, and parity.

Main Outcome Measure  Specialist-confirmed diagnosis of ASDs.

Results  At the end of follow-up, 270 children in the study sample had been diagnosed with ASDs: 114 with autistic disorder, 56 with Asperger syndrome, and 100 with PDD-NOS. In children whose mothers took folic acid, 0.10% (64/61 042) had autistic disorder, compared with 0.21% (50/24 134) in those unexposed to folic acid. The adjusted OR for autistic disorder in children of folic acid users was 0.61 (95% CI, 0.41-0.90). No association was found with Asperger syndrome or PDD-NOS, but power was limited. Similar analyses for prenatal fish oil supplements showed no such association with autistic disorder, even though fish oil use was associated with the same maternal characteristics as folic acid use.

Conclusions and Relevance  Use of prenatal folic acid supplements around the time of conception was associated with a lower risk of autistic disorder in the MoBa cohort. Although these findings cannot establish causality, they do support prenatal folic acid supplementation. http://jama.jamanetwork.com/article.aspx?articleid=1570279

One of the implications of this study is the necessity that women receive adequate prenatal care and women really should have pre-pregnancy counseling and care.

United Health Foundation reports Prenatal Care (1990 – 2011): Percentage of pregnant women receiving adequate prenatal care, as defined by Kessner Index:

Prenatal care is a critical component of health care for pregnant women and a key step towards having a healthy pregnancy and baby. Early prenatal care is especially important because many important developments take place during the first trimester, screenings can identify babies or mothers at risk for complications and health care providers can educate and prepare mothers for pregnancy.  Women who receive prenatal care have consistently shown better outcomes than those who did not receive prenatal care[1]. Mothers who do not receive any prenatal care are three times more likely to deliver a low birth weight baby than mothers who received prenatal care, and infant mortality is five times higher[2].  Early prenatal care also allows health care providers to identify and address health conditions and behaviors that may reduce the likelihood of a healthy birth, such as smoking and drug and alcohol abuse.                                           http://www.americashealthrankings.org/All/PrenatalCare/2012

Given this recent study it is imperative that ALL women receive prenatal care particularly poor and those women at risk of difficult pregnancies.

Related:

Autism and children of color                                                https://drwilda.com/tag/children-of-color-with-autism/

Archives of Pediatrics and Adolescent Medicine study: Kids with autism more likely to be bullied                                   https://drwilda.com/2012/09/06/archives-of-pediatrics-and-adolescent-medicine-study-kids-with-autism-more-likely-to-be-bullied/

Father’s age may be linked to Autism and Schizophrenia https://drwilda.com/2012/08/26/fathers-age-may-be-linked-to-autism-and-schizophrenia/

Chelation treatment for autism might be harmful  https://drwilda.com/2012/12/02/chelation-treatment-for-autism-might-be-harmful/

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One Response to “Journal of American Medical Association study: Folic acid may reduce autism risk”

  1. Basketball Wives Season 3 April 30, 2013 at 4:24 pm #

    Thanks for sharing your info. I really appreciate your efforts and I am waiting for your next write ups thanks
    once again.

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