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While autism is believed to be a multifactorial disorder with role for both genetics and environment, the precise mechanisms remain mired in debate. Epidemiologic studies help shed light on the various combination of factors that may be involved. However, the data has thus far been mixed.
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Dr. Gardener and colleagues from the Department of Epidemiology, Harvard School of Public Health, Boston, MA conducted a metaanalysis of the studies on the effect of perinatal and neonatal risk factors that contribute to risk for autism. These investigators published their findings in the journal Pediatrics 2011.
Design of autism perinatal-neonatal risk factor study:
The investigators studied a variety of databases including PubMed, Embase, and PsycInfo and looked for studies seeking perinatal and neonatal risk factors associated with autism spectrum disorders.
Forty studies met the predetermined criteria for inclusion. a-analysis. For each exposure
A summary effect estimate was calculated for each exposure or potential risk factor. Meta-regression was carried out seek methodological factors that could explain between-study variability.
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Results of the autism perinatal-neonatal risk factor study:
The investigators analyzed over 60 potential perinatal and neonatal factors. They identified the following factors associated with autism:
- Abnormal presentation
- Umbilical-cord complications
- Fetal distress
- Baby birth trauma, low 5-minute Apgar score
- Multiple births
- Maternal hemorrhage
- Summer birth
- Low birth weight
- Small for gestational age
- Congenital malformations
- Feeding difficulties
- Meconium aspiration
- Anemia in the baby
- Blood group ABO or Rh incompatibility
- Jaundice (Amin et al recently confirmed total bilirubin level as a rsk factor except in pre-term infants.)
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The metaanalysis refuted the following as having significant effect on risk for autism:
- Anesthesia
- Assisted vaginal delivery
- Postterm birth
- High birth weight
- Size of the head
A recent French study while confirming some of the above results documented the following maternal factors as increasing risk for autism.
- Pre-eclampsia
- Diabetes
- Vomiting
- Infections during pregnancy
- Maternal stress during pregnancy
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Dr. Minocha's comments on autism perinatal-neonatal risk factors
- It is unclear if the factors above are mere associations or represent cause-effect relationship.
- It is possible that improved prenatal and obstetric care results in survival more more babies with brain damage and the resulting neurodevelopmental disorders.
- There is probabaly not one factor that singly may have a significant role in pathogenesis of autism spectrum disorders.
- It appears more likely that risk may be related more so to a combination of factors or conditions encompassing compromises healthy pregnancy, perinatal and neonatal state.
- Dr. Dodds and colleagues from the Department of Obstetrics and Gynaecology, Dalhousie University in Canada argue that while maternal/obstetric factors may play a significant role in those with low genetic risk, the role is diminished in those at high genetic risk.
Is It Leaky Gut or Leaky Gut Syndrome?
Wall Street Journal Best Seller Dr. M's Seven-X Plan for Digestive Health
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Is It Leaky Gut or Leaky Gut Syndrome?
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Wall Street Journal Best Seller Dr. M's Seven-X Plan for Digestive Health
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