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Twenty Years Later

Age of Autism Science Summary: Perinatal and neonatal risk factors for autism: a comprehensive meta-analysis.

Science post imageManaging Editor's Note: We'll be posting science abstracts for your information.

Pediatrics. 2011 Aug;128(2):344-55. Epub 2011 Jul 11.

Perinatal and neonatal risk factors for autism: a comprehensive meta-analysis.

Gardener H, Spiegelman D, Buka SL.

Source

Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA. hgardener@med.miami.edu

Abstract

BACKGROUND:

The etiology of autism is unknown, although perinatal and neonatal exposures have been the focus of epidemiologic research for over 40 years.

OBJECTIVE:

To provide the first review and meta-analysis of the association between perinatal and neonatal factors and autism risk.

METHODS:

PubMed, Embase, and PsycInfo databases were searched for studies that examined the association between perinatal and neonatal factors and autism through March 2007. Forty studies were eligible for the meta-analysis. For each exposure, a summary effect estimate was calculated using a random-effects model. Heterogeneity in effect estimates across studies was examined, and, if found, a meta-regression was conducted to identify measured methodological factors that could explain between-study variability.

RESULTS:

Over 60 perinatal and neonatal factors were examined. Factors associated with autism risk in the meta-analysis were abnormal presentation, umbilical-cord complications, fetal distress, birth injury or trauma, multiple birth, maternal hemorrhage, summer birth, low birth weight, small for gestational age, congenital malformation, low 5-minute Apgar score, feeding difficulties, meconium aspiration, neonatal anemia, ABO or Rh incompatibility, and hyperbilirubinemia. Factors not associated with autism risk included anesthesia, assisted vaginal delivery, postterm birth, high birth weight, and head circumference.

CONCLUSIONS:

There is insufficient evidence to implicate any 1 perinatal or neonatal factor in autism etiology, although there is some evidence to suggest that exposure to a broad class of conditions reflecting general compromises to perinatal and neonatal health may increase the risk. Methodological variations were likely sources of heterogeneity of risk factor effects across studies.

PMID:

21746727

[PubMed - indexed for MEDLINE]

Comments

oneVoice

Amy Tuteur MD. She has NO clue about the benefits of delayed cord clamping. One of the greatest benefits of delayed cord
clamping is that the cord blood expands the lungs/alveoli
and allows the newborn's transition to extra-uterine life
successfully,very often (99.9%) without the need of resuscitation.The newborn will triple his/her birth weight in the first year and that means babies need to have iron reserves at the beginning to provide the body with future oxygen needs.Some of the red cells will break down
(this is a normal process) and iron
will get recycled to build new red blood cells,the bilirubin will get excreted by the kidneys and digestive system.
Dr. Amy Tuteur is just another pHarma paid doc that confuses clients about the truth and trying to sell books with her false ideas.

oneVoice

Sorry,I would like to add (8)to the list because delayed clamping will increase the newborns iron reserves and will help to prevent anemia on the long run.I also would like to disclose that I have a son with autism (conflict of interest).This is a very important issue for all newborns and mothers.At the time of the introduction of oxytocin to new mothers- the effects of this intervention on the newborns had NOT been examined. At the time of the birth a transition takes place from a fluid environment to a pulmunary respiration and great physiological changes are taking place in those few minutes. Thank you for your attention and posting this important info.

oneVoice

Eileen Nicole Simon,you are on the right track.The interventions that used in Obstetrics my major concerns.If
delayed clamping is practiced (my recommendation and supported with new research)the newborns still receive
placental blood and oxygen while the alveolis in the lung
begin to fill with air and the amniotic fluid moves out.This is like a double insurance for the newborn as (1) some of the fetal blood that is in the placenta will return to the newborn's circulation;(2)newborns will have a higher
blood volume,more hemoglobin and higher oxygen carrying capability with better blood pressure;(3)newborns will have more stem cells to complete the wiring that needs to be done
in the immature central nervous system;(4)newborns will be better able to maintain their temperature,due to better circulation;(5)the audiology center will have higher blood
volume,so no hypoxia can occur in this sensitive area;(6)
newborns may have more hyperbillirubinemia,but this is a minor problem that usually corrects with increased feeding
and phototherapy.It is important that immediate clamping of the cord STOPS,this started with the introduction of Oxytocin and "active management" of 3rd or placental stage.Oxytocin can be given later if
there are clinical indications present,or after the placenta has delivered (as it is done in Europe). Vaccinations is another concern,that I will return to.

Eileen Nicole Simon

I submitted an e-letter to this article last July. The important thing is how the brain is affected. With any of the perinatal problems they listed, oxygen insufficiency is the great worry. It's been more than 50 years since experimental asphyxiation of monkeys at birth revealed ischemic damage in nuclei of the auditory pathway, which is essential for human children to learn to speak.

Ischemic damage leads to breakdown of the blood-brain barrier. Therefore, the hep-B given in the neonatal nursery will enter these damaged auditory nuclei and compound the problem.

If any one might be interested, my e-letter is at
http://pediatrics.aappublications.org/content/128/2/344.abstract/reply#pediatrics_el_51533

I will continue to try to point out exactly how ischemic and/or plus toxic injury can disrupt brain systems essential for learning to speak. . .


Benedetta

Please set me straight anyone that knows the language better.
My translation:
They took 40 studies done by other scientists. These 40 studies were chosen because they had stats in them; that is-i.e. - that is just those that had math in them.

Measurable math that could be plugged into some kind of algerbaric formula to get the answer to which of the over 60 possibilities it could be (by the way, Hep B at birth or the DPT shot at around two months or any of those later boosters were not included in the "over 60 possibilities")

The answer please:


It is not one thing but a broad ---- oh what did they say --

"broad class of conditions"

I know what the word conditions means.
I thought I knew what class means.
I just don't know what the phrase "broad class of conditions", means?

Class; lots of students learning a subject under a teacher
Class; Used in naming animals, plants, and bacteria as in Kingdom, Phylum, Class,Order,Family, genus, species.
"I remember that from my beloved botany professor (40 years ago) who said remember the sentence; King Phillip came over from Greece, Saturday.

Conditions are classed?
Over 60 conditions too, which are a lot.
So, like all good science papers they "assumed" that it has to be one of the over 60 conditions that they chose to measure; that is those conditions that were in other science papers, and had the right kind of math.

- But there was one condition left out, wasn't there?
One left out those "over 60 conditions" and it was the very one that is the most controversial - the one that CDC spent lots of money to a foreign country, to a foreign Univerisity, to a foreign scientist of DANE LAND to study it. The very conditon that the AGE of Autism website is all about. THe very conditon that many brave Vaccine Compensation Court winners stood up and claimed was the cause. The very one the Jon Poling won a great deal of money from the vaccine compensation court- that his daughter's injuries from a vaccine caused mitrochidrial cytopathy. The very condition that caused a very long, public trial for three British physcians for over a year to take their medical liscense for claiming vaccines cause autism.

But then if you look at just the first author on this study, Gardner; and see what else he has published, you get the idea that it is a little man sitting in a Northern Manhatten medical library with a very fancy caculator close at hand.

What a tedious, dull, unproductive life.

Jenny

Does anyone besides me hate the "conclusions" sections of research? I'm sure it's valuable in some aspects, but I feel like in many cases I am perfectly able to look at the results and form my own conclusions.

I guess the follow up to this one, then, would be what are the environmental (controllable) sources that could CAUSE each of these factors. Then one could examine and form a pregnancy plan of how to avoid those causitive, and even corralated factors, thereby lowering the risk of autism in future births. Let's start with feeding issues - would loss of suckling refex after a hep. B shot at birth be of concern?

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