Johns Hopkins Bloomberg School of Public Health study: Evidence that autism spectrum disorder risks may begin in utero

31 Jan

The number of children with autism appears to be growing. The Centers for Disease Control and Prevention provides statistics on the number of children with autism in the section Data and Statistics:

Prevalence

  • It is estimated that between 1 in 80 and 1 in 240 with an average of 1 in 110 children in the United States have an ASD. [Read article]

  • ASDs are reported to occur in all racial, ethnic, and socioeconomic groups, yet are on average 4 to 5 times more likely to occur in boys than in girls.  However, we need more information on some less studied populations and regions around the world. [Read article]

  • Studies in Asia, Europe, and North America have identified individuals with an ASD with an approximate prevalence of 0.6% to over 1%. A recent study in South Korea reported a prevalence of 2.6%. [Data table ]

  • Approximately 13% of children have a developmental disability, ranging from mild disabilities such as speech and language impairments to serious developmental disabilities, such as intellectual disabilities, cerebral palsy, and autism.  [Read article] http://www.cdc.gov/ncbddd/autism/data.html

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

Science Daily reported in Obesity, diabetes in mom increases risk of autism in child:

Children born to obese women with diabetes are more than four times as likely to be diagnosed with autism spectrum disorder than children of healthy weight mothers without diabetes, new Johns Hopkins Bloomberg School of Public Health research suggests.

The findings, to be published Jan. 29 in the journal Pediatrics, highlight what has become a leading theory about autism, that the risk likely develops before the child is even born.

“We have long known that obesity and diabetes aren’t good for mothers’ own health,” says study leader Xiaobin Wang, MD, ScD, MPH, the Zanvyl Krieger Professor in Child Health at the Bloomberg School and director of the Center on the Early Life Origins of Disease. “Now we have further evidence that these conditions also impact the long-term neural development of their children.”

Autism spectrum disorder is a neurodevelopmental condition characterized by severe deficits in socialization, verbal and nonverbal communication and repetitive behaviors. Since the 1960s, the prevalence rates have skyrocketed, with one in 68 U.S. children now affected by it, according to the U.S. Centers for Disease Control and Prevention. Obesity and diabetes have also risen to epidemic levels in women of reproductive age over the same time period.

For the study, the researchers analyzed 2,734 mother-child pairs, a subset of the Boston Birth Cohort recruited at the Boston Medical Center at birth between 1998 and 2014. They collected data on maternal pre-pregnancy weight and whether the mothers had diabetes before getting pregnant or whether they developed gestational diabetes during pregnancy. They also followed up the children from birth through childhood via postnatal study visits and review of electronic medical records. They identified 102 children who were diagnosed with autism spectrum disorder over the course of the study. Those children with mothers who were both diabetic and obese were more than four times as likely to develop autism compared to children born to normal weight mothers without diabetes, they found.

“Our research highlights that the risk for autism begins in utero,” says co-author M. Daniele Fallin, PhD, chair of the Bloomberg School’s Department of Mental Health and director of the Wendy Klag Center for Autism and Developmental Disabilities. “It’s important for us to now try to figure out what is it about the combination of obesity and diabetes that is potentially contributing to sub-optimal fetal health.”

Previous studies had suggested a link between maternal diabetes and autism, but this is believed to be the first to look at obesity and diabetes in tandem as potential risk factors….                               http://www.sciencedaily.com/releases/2016/01/160129091631.htm

Citation:

Obesity, diabetes in mom increases risk of autism in child

Date:         January 29, 2016

Source:     Johns Hopkins Bloomberg School of Public Health

Summary:

Children born to obese women with diabetes are more than four times as likely to be diagnosed with autism spectrum disorder than children of healthy weight mothers without diabetes, new research suggests.

Journal Reference:

  1. Mengying Li; M. Daniele Fallin; Anne Riley; Rebecca Landa; Sheila O. Walker; Michael Silverstein; Deanna Caruso; Colleen Pearson; Shannon Kiang; Jamie Lyn Dahm; Xiumei Hong; Guoying Wang; Mei-Cheng Weng; Barry Zuckerman and Xiaobin Wang. The association of maternal obesity and diabetes with autism and other developmental disabilities. Pediatrics, January 2016 DOI: 10.1542/peds.2015-2206

Here is the press release from Johns Hopkins:

January 29, 2016

Obesity, Diabetes in Mom Increases Risk of Autism in Child

New study offers new evidence that autism spectrum disorder risks may begin in utero

Children born to obese women with diabetes are more than four times as likely to be diagnosed with autism spectrum disorder than children of healthy weight mothers without diabetes, new Johns Hopkins Bloomberg School of Public Health research suggests.

The findings, to be published Jan. 29 in the journal Pediatrics, highlight what has become a leading theory about autism, that the risk likely develops before the child is even born.

“We have long known that obesity and diabetes aren’t good for mothers’ own health,” says study leader Xiaobin Wang, MD, ScD, MPH, the Zanvyl Krieger Professor in Child Health at the Bloomberg School and director of the Center on the Early Life Origins of Disease. “Now we have further evidence that these conditions also impact the long-term neural development of their children.”

Autism spectrum disorder is a neurodevelopmental condition characterized by severe deficits in socialization, verbal and nonverbal communication and repetitive behaviors. Since the 1960s, the prevalence rates have skyrocketed, with one in 68 U.S. children now affected by it, according to the U.S. Centers for Disease Control and Prevention. Obesity and diabetes have also risen to epidemic levels in women of reproductive age over the same time period.

For the study, the researchers analyzed 2,734 mother-child pairs, a subset of the Boston Birth Cohort recruited at the Boston Medical Center at birth between 1998 and 2014. They collected data on maternal pre-pregnancy weight and whether the mothers had diabetes before getting pregnant or whether they developed gestational diabetes during pregnancy. They also followed up the children from birth through childhood via postnatal study visits and review of electronic medical records. They identified 102 children who were diagnosed with autism spectrum disorder over the course of the study. Those children with mothers who were both diabetic and obese were more than four times as likely to develop autism compared to children born to normal weight mothers without diabetes, they found.

“Our research highlights that the risk for autism begins in utero,” says co-author M. Daniele Fallin, PhD, chair of the Bloomberg School’s Department of Mental Health and director of the Wendy Klag Center for Autism and Developmental Disabilities. “It’s important for us to now try to figure out what is it about the combination of obesity and diabetes that is potentially contributing to sub-optimal fetal health.”

Previous studies had suggested a link between maternal diabetes and autism, but this is believed to be the first to look at obesity and diabetes in tandem as potential risk factors.

Along with pre-conception diabetes, children of obese mothers who developed gestational diabetes during pregnancy were also at a significantly higher risk of being diagnosed with autism.

The biology of why obesity and diabetes may contribute to autism risk isn’t well understood. Obesity and diabetes in general cause stress on the human body, the researchers say. Previous research suggests maternal obesity may be associated with an inflammation in the developing fetal brain. Other studies suggest obese women have less folate, a B-vitamin vital for  human development and health.

The researchers say that women of reproductive age who are thinking about having children need to not only think about their obesity and diabetes status for their own health, but because of the implications it could have on their children. Better diabetes and weight management could have lifelong impacts on mother and child, they say.

“In order to prevent autism, we may need to consider not only pregnancy, but also pre-pregnancy health,” Fallin says.

“The association of maternal obesity and diabetes with autism and other developmental disabilities” was written by Mengying Li; M. Daniele Fallin; Anne Riley; Rebecca Landa; Sheila O. Walker; Michael Silverstein; Deanna Caruso; Colleen Pearson; Shannon Kiang; Jamie Lyn Dahm; Xiumei Hong; Guoying Wang; Mei-Cheng Weng; Barry Zuckerman and Xiaobin Wang.

The parent study was supported in part by the March of Dimes, the National Institute of Environmental Health Sciences (R21 ES011666) and the National Institute of Child Health and Human Development (2R01 HD041702). The Pediatrics study is supported in part by the Ludwig Family Foundation; the National Institute of Allergy and Infectious Diseases (U01AI90727 and R21AI079872) and the Maternal and Child Health Bureau (R40MC27442).

# # #

Media contacts for the Johns Hopkins Bloomberg School of Public Health: Barbara Benham at 410-614-6029 or bbenham1@jhu.edu and Stephanie Desmon at 410-955-7619 or sdesmon1@jhu.edu.

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/

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

https://drwilda.com/tag/folic-acid-in-pregnancy-may-lower-autism-risk/

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One Response to “Johns Hopkins Bloomberg School of Public Health study: Evidence that autism spectrum disorder risks may begin in utero”

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  1. Diabetes and obesity linked to autism in new Hopkins study - January 31, 2016

    […] A press release from Johns Hopkins University describing the details of the recent study can be found here. […]

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