"Our study provides strong evidence that controlling feverswhile pregnant may be effective in modifying the risk of having achild with autism or developmental delay," said Ousseny Zerbo,lead author of the study, who was a Ph.D. candidate with UC Daviswhen the study was conducted and is now a postdoctoral researcherwith the Kaiser Permanente Northern California Division ofResearch. "We recommend that pregnant women who develop fevertake anti-pyretic medications and seek medical attention if theirfever persists." Published online in the Journal of Autism and Developmental Disorders , the study is believed to be the first to consider how fever fromany cause, including the flu, and its treatment during pregnancycould affect the likelihood of having a child with autism ordevelopmental delay. The results are based on data from a large, case-controlinvestigation known as the Childhood Autism Risk from Genetics andthe Environment (CHARGE) Study. |
Another recent study based onCHARGE data found that mothers who were obese or diabetic had ahigher likelihood of having children with autism. Irva Hertz-Picciotto, a professor of public health sciences at UCDavis and principal investigator of CHARGE, pointed out that feveris produced by acute inflammation -- the short-term, natural immunesystem reaction to infection or injury -- and that chronicinflammation, which no longer serves a beneficial purpose and candamage healthy tissue, may be present in mothers with metabolicabnormalities like diabetes and obesity. "Since an inflammatory state in the body accompanies obesityand diabetes as well as fever," said Hertz-Picciotto,"the natural question is: Could inflammatory factors play arole in autism?" She explained that when people are infected by bacteria or viruses,the body generally reacts by mounting a healing response thatinvolves the release of pro-inflammatory cytokines from white bloodcells into the bloodstream. Some cytokines are able to cross theplacenta, and therefore could reach the fetal central nervoussystem, potentially altering levels of neurotransmitters and braindevelopment. "We definitely think more research is necessary to pinpointthe ways that inflammation could alter brain development,"said Hertz-Picciotto.
CHARGE includes an ethnically diverse population of children aged 2to 5 years born in California and living in Northern California.The current study included 538 children with autism, 163 childrenwith developmental delay but not autism, and 421 typicallydeveloping children whose mothers answered standardizedquestionnaires about whether they had the flu and/or fever duringpregnancy and if they took medications to treat their illnesses. The results showed that flu during pregnancy was not associatedwith greater risks of having a child with autism or developmentaldelay. Fever from any cause during pregnancy, however, was far morelikely to be reported by mothers of children with autism (2.12times higher odds) or developmental delay (2.5 times higher odds),as compared with mothers of children who were developing typically.For children of mothers who took anti-fever medication, the risk ofautism was not different from the risk in children whose mothersreported no fever. According to Irva Hertz-Picciotto, results based on CHARGE data arenoteworthy because of the study's large population-based sample anddetailed information on participants.
Other CHARGE evaluations havefound that taking prenatal vitamins prior to and during the firstmonth of pregnancy may help prevent autism and that living near afreeway or in areas with high regional air pollution is associatedwith higher risk of autism in children. "CHARGE has obtained a wealth of environmental, demographicand medical information on young children and their parents andprovides a solid basis for a variety of epidemiologicstudies," said Hertz-Picciotto. "Those studies arehelping us find ways to protect childhood neurodevelopment." In addition to Zerbo and Hertz-Picciotto, other UC Davis authorswere Robin Hansen of the Department of Pediatrics, Sally Ozonoff ofthe Department of Psychiatry and Behavioral Sciences, Cheryl Walkerof the Department of Obstetrics and Gynecology and Ana-Maria Iosifof the Department of Public Health Sciences. Hertz-Picciotto,Hansen, Ozonoff and Walker are also affiliated with the UC DavisMIND (Medical Investigation of Neurodevelopmental Disorders)Institute.
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