Yale study: Abnormalities in placenta may predict autism at birth

26 Aug

Autism is a disease where one should not make assumptions. Many folk of color don’t think that autism affects them. Moi wrote in Autism and children of color:
Lauran Neergaard reported in the Huffington Post article, Autism Not Diagnosed As Early In Minority Children: Study:

Her preliminary research suggests even when diagnosed in toddlerhood, minority youngsters have more severe developmental delays than their white counterparts. She says cultural differences in how parents view developmental milestones, and how they interact with doctors, may play a role.
Consider: Tots tend to point before they talk, but pointing is rude in some cultures and may not be missed by a new parent, Landa says. Or maybe mom’s worried that her son isn’t talking yet but the family matriarch, her grandmother, says don’t worry – Cousin Harry spoke late, too, and he’s fine. Or maybe the pediatrician dismissed the parents’ concern, and they were taught not to question doctors.
It’s possible to detect autism as early as 14 months of age, and the American Academy of Pediatrics recommends that youngsters be screened for it starting at 18 months. While there’s no cure, behavioral and other therapies are thought to work best when started very young.
Yet on average, U.S. children aren’t diagnosed until they’re about 4 1/2 years old, according to government statistics.
And troubling studies show that white kids may be diagnosed with autism as much as a year and a half earlier than black and other minority children, says University of Pennsylvania autism expert David Mandell, who led much of that work. Socioeconomics can play a role, if minority families have less access to health care or less education.
But Mandell says the full story is more complex. One of his own studies, for example, found that black children with autism were more likely than whites to get the wrong diagnosis during their first visit with a specialist.
http://www.huffingtonpost.com/2012/02/28/autism-not-diagnosed-as-early-in-minority-children_n_1306272.html

See, New Study Shows Minority Toddlers with Autism are More Delayed than Affected Caucasian Peers http://www.kennedykrieger.org/overview/news/new-study-shows-minority-toddlers-autism-are-more-delayed-affected-caucasian-peers

KING5 Healthlink reported in the story, Placenta may help diagnose autism after birth:

One in every 50 school children in the United States will be diagnosed with autism. It can take doctors years to identify the disorder, which delays much-needed treatment. But new research may help doctors predict a child’s risk of developing autism — at birth!
Early detection of autism is essential, said Dr. Harvey J. Kliman, a research scientist.
“The brain is completely unformed at birth. We can change behaviors very early,” he said.
A new study suggests that the placenta, which provides nutrients to the baby from the mother, may help doctors diagnose autism shortly after birth.
Researchers analyzed placentas from 217 births and found that in families at high risk for autism, there were more abnormal folds and creases in the placentas.
It will be at least a year before researchers know which children whose placentas were studied will have autism.
Currently, only 10 percent to 15 percent of placentas are ever analyzed, usually because of pregnancy complications or the death of a newborn. http://www.king5.com/health/childrens-healthlink/Placenta-may-help-diagnose-autism-after-birth-220419381.html

Here is the press release from Yale:

Autism risk spotted at birth in abnormal placentas
By Karen N. Peart
April 25, 2013
Abnormal placental folds signal autism risk at birth. (Original illustration by Patrick Lynch, Yale University)
Researchers at the Yale School of Medicine have figured out how to measure an infant’s risk of developing autism by looking for abnormalities in his/her placenta at birth, allowing for earlier diagnosis and treatment for the developmental disorder. The findings are reported in the April 25 online issue of Biological Psychiatry.
One out of 50 children are diagnosed with an autism spectrum disorder in the United States each year, according to the Centers for Disease Control and Prevention (CDC), but the diagnosis is usually made when these children are 3 to 4 years of age or older. By then the best opportunities for intervention have been lost because the brain is most responsive to treatment in the first year of life.
Senior author Dr. Harvey Kliman, research scientist in the Department of Obstetrics, Gynecology & Reproductive Sciences at the Yale School of Medicine, and research collaborators at the MIND Institute at the University of California, Davis, have found that abnormal placental folds and abnormal cell growths called trophoblast inclusions are key markers to identify newborns who are at risk for autism.
Kliman and his team examined 117 placentas from infants of at-risk families, those with one or more previous children with autism. These families were participating in a study called Markers of Autism Risk in Babies – Learning Early Signs. Kliman compared these at-risk placentas to 100 control placentas collected by the UC Davis researchers from the same geographic area.
The at-risk placentas had as many as 15 trophoblast inclusions, while none of the control placentas had more than two trophoblast inclusions. Kliman said a placenta with four or more trophoblast inclusions conservatively predicts an infant with a 96.7% probability of being at risk for autism.
Currently, the best early marker of autism risk is family history. Couples with a child with autism are nine times more likely to have another child with autism. Kliman said that when these at-risk families have subsequent children they could employ early intervention strategies to improve outcomes. “Regrettably couples without known genetic susceptibility must rely on identification of early signs or indicators that may not overtly manifest until the child’s second or third year of life,” said Kliman.
“I hope that diagnosing the risk of developing autism by examining the placenta at birth will become routine, and that the children who are shown to have increased numbers of trophoblast inclusions will have early interventions and an improved quality of life as a result of this test,” Kliman added.
Other authors on the study include Kaitlin Anderson, Kristin Milano, and Saier Ye of Yale University; and Cheryl Walker, Daniel Tancredi, Isaac Pessah, and Irva Hertz-Picciotto of UC Davis.
This work was supported by the National Institutes of Health (1 P01 ES11269 and R01 ES 015359), the U.S. Environmental Protection Agency through the Science to Achieve Results (STAR) program (R829388 and R833292), the MIND Institute at the University of California, Davis, and the Yale University Reproductive and Placental Research Unit.
Citation: Biological Psychiatry, Published online (April 25, 2013)

Citation:

Trophoblast Inclusions Are Significantly Increased in the Placentas of Children in Families at Risk for Autism
Received 15 October 2012; received in revised form 23 February 2013; accepted 10 March 2013. published online 26 April 2013.
Background
Gestation is a critical window for neurodevelopmental vulnerability. This study examined whether the presence of trophoblast inclusions (TIs) in the placenta could serve as a predictor for children at elevated risk for autism spectrum disorder (ASD).
Methods
Placentas were obtained from 117 births in the MARBLES (Markers of Autism Risk in Babies—Learning Early Signs) cohort of families who have one or more previous biological children with ASD, placing their newborn at elevated risk for neurodevelopmental compromise. Control samples were obtained from 100 uncomplicated term pregnancies of multiparous women with one or more typically developing biological children. Frequency of TIs was compared across the two groups.
Results
Placentas from at-risk pregnancies had an eightfold increased odds of having two or more TIs compared with control samples (odds ratio: 8.0, 95% confidence interval: 3.6–18.0). The presence of≥2 TIs yielded a sensitivity of 41% and a specificity of 92% for predicting ASD risk status, whereas≥4 TIs yielded a sensitivity of 19%, a specificity of 99.9%, and a positive likelihood ratio of 242 and conservatively predicted an infant with a 74% probability of being at risk for ASD.
Conclusions
Our findings suggest that the placentas from women whose fetuses are at elevated risk for autism are markedly different from control placentas. These differences are manifested histologically as TIs. Their identification has the possibility of identifying newborns at risk for ASD who might benefit from targeted early interventions aimed at preventing or ameliorating behavioral symptoms and optimizing developmental outcomes. http://www.biologicalpsychiatryjournal.com/article/S0006-3223(13)00249-7/abstract

Parents must pay attention to whether their children are developing within the parameters of what is appropriate for the child’s age.

Resources:

For more information on neurological disorders or research programs funded by the National Institute of Neurological Disorders and Stroke, contact the Institute’s Brain Resources and Information Network (BRAIN) at:

BRAIN
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Association for Science in Autism Treatment
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http://www.asatonline.org

Autism National Committee (AUTCOM)
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http://www.autcom.org

Autism Network International (ANI)
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http://www.ani.ac

Autism Research Institute (ARI)
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Tel: 866-366-3361
Fax: 619-563-6840

Autism Science Foundation
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Tel: 646-723-3978
Fax: 212-228-3557

Autism Society of America
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Tel: 301-657-0881 800-3AUTISM (328-8476)
Fax: 301-657-0869

Autism Speaks, Inc.
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Tel: 212-252-8584 California: 310-230-3568
Fax: 212-252-8676 Birth Defect Research for Children, Inc.
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Tel: 407-895-0802

MAAP Services for Autism, Asperger Syndrome, and PDD
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Tel: 219-662-1311
Fax: 219-662-1315

National Dissemination Center for Children with Disabilities
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Tel: 800-695-0285 202-884-8200
Fax: 202-884-8441

National Institute of Child Health and Human Development (NICHD)
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Tel: 301-496-5133
Fax: 301-496-7101 National Institute on Deafness and Other Communication Disorders Information Clearinghouse
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Related:

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/

Autism and children of color
https://drwilda.com/tag/autism-not-diagnosed-as-early-in-minority-children/

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/

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

University of Connecticut study: Some children with autism may be ‘cured’ with intense early therapy https://drwilda.com/tag/optimal-outcome-in-individuals-with-a-history-of-autism/

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