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 When women are both obese and have diabetes, the autism risk for
their child is at least quadrupled, researchers report in the
journal Pediatrics.
“In terms of absolute risk, compared to common pediatric diseases
such as obesity and asthma, the rate of autism spectrum disorder (ASD)
in the U.S. population is relatively low, however, the personal,
family and societal impact of ASD is enormous,” said senior study
author Dr. Xiaobin Wang, a public health and pediatrics researcher
at Johns Hopkins University in Baltimore.
About one in 68 children have ASD, which includes autism as well as
Asperger syndrome and other pervasive developmental disorders,
according to the U.S. Centers for Disease Control and Prevention.
Put another way, that’s about 1.5 percent of U.S. children. The
study findings suggest the risk rises closer to about 3 percent of
babies born to women who are obese or have diabetes, and approaches
5 percent to 6 percent when mothers have the combination of obesity
and diabetes.
To explore the connection between autism and maternal health, Wang
and colleagues analyzed data on 2,734 mother-child pairs who were
followed at Boston Medical Center between 1998 and 2014.
Most of the children, 64 percent, weren’t diagnosed with ASD or any
other development disorders, but there were 102 kids who did receive
an ASD diagnosis.
Compared with typically developing kids, those with ASD were more
likely to be boys, born preterm and at a low birth weight. Mothers
of children with ASD were likely to be older, obese and to have
diabetes diagnosed before or during pregnancy.
Maternal obesity was linked to a 92 percent increased risk for
autism on its own, while diabetes diagnosed before pregnancy was
associated with more than triple the risk.
When women both had diabetes and were obese, the autism risk
compared to women with neither condition rose roughly four-fold if
the diabetes was diagnosed during pregnancy and almost five-fold if
diabetes was present before they conceived.
While the exact reason for these connections isn’t clear, it’s
possible that increased inflammation, nutrients and hormones linked
to diabetes and obesity may be responsible for the added autism
risk, said Elinor Sullivan, a biology and neuroscience researcher at
the University of Portland, in Oregon, who wasn’t involved in the
study.
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“These factors impact how the brain develops,” Sullivan said. “The
risk for autism would be further increased if women were obese and
had diabetes as the levels of inflammatory factors and nutrients
that the offspring would be exposed to would be further elevated.”
One limitation of the study is that some children with ASD may have
been misclassified or had only tentative diagnoses, the authors
note. In addition, it’s possible that what’s known as selection bias
led more children with developmental delays to be included in the
study.
The findings are important because more than a third of women of
childbearing age are obese, roughly one in 10 have diabetes, and an
estimated 2 percent to 10 percent of mothers develop diabetes during
pregnancy, the authors note. Often, these conditions can be
addressed prior to pregnancy.
“It is really good advice for women to achieve a healthy weight and
get diabetes under control before becoming pregnant for many reasons
not related to autism,” Renee Gardner, a public health researcher at
the Karolinska Institute in Solna, Sweden, who wasn’t involved in
the study said by email.
“The risks to both the child’s health and the mother’s health,
including risk of serious pregnancy complications, C-section
delivery and even still birth are greatly increased if the mother is
obese or has uncontrolled diabetes,” Gardner added.
SOURCE: http://bit.ly/1qyV1oi Pediatrics, online January 29, 2016.
[© 2016 Thomson Reuters. All rights
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