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Link Between Gestational Diabetes And Autism

Is Gestational Diabetes Linked To Autism?

Is Gestational Diabetes Linked To Autism?

HealthDay Reporter TUESDAY, April 14, 2015 (HealthDay News) -- Pregnancy-related diabetes may increase the risk a child will develop autism, new research suggests. The blood sugar disorder, known as gestational diabetes, was linked to a moderately increased risk for an autism spectrum disorder in a study of more than 320,000 U.S. children, said study researcher Anny Xiang, director of statistical research at Kaiser Permanente Southern California. However, it was an "observational study" and cannot prove a direct cause-and-effect relationship between gestational diabetes -- which affects up to 9 percent of pregnant women in the United States -- and autism. "To provide perspective, this increased risk [of autism] seen with early gestational diabetes translated to around seven additional cases per 1,000 pregnancies over that seen with pregnancies that didn't involve [gestational] diabetes," Xiang said. No increased risk of autism was associated with type 2 diabetes diagnosed before pregnancy, the study found. One expert urged caution in interpreting the findings. "Although this study suggests that development of gestational diabetes during the first or second trimester of pregnancy puts a fetus at increased risk for an autism spectrum disorder, the magnitude of this risk -- if real -- is relatively small," said Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at the Cohen Children's Medical Center of New York in New Hyde Park, N.Y. "Although researchers are eager to identify as many risk factors for autism as possible, the reality is that many different health exposures and risk factors have been linked to autism spectrum disorders," said Adesman, who was not involved in the study. Previous studies have produced mixed findings about whether gestational Continue reading >>

Autism: The Link Between Gestational Diabetes & Baby’s Autism Risk

Autism: The Link Between Gestational Diabetes & Baby’s Autism Risk

While the incidence of autism spectrum disorder has increased in recent years, what’s behind it remains relatively mysterious and even controversial. But a major study could shed new light on some of the maternal health factors that may increase children’s risk of developing the condition. Autism is a neurodevelopmental disorder marked by difficulties with communication and social interaction as well as repetitive or obsessive behaviors. The range and severity of symptoms can vary widely. The study, which was released Friday and appears in the February issue of the journal Pediatrics, followed almost 3,000 children who visited the Boston Medical Center between 1998 and 2014. It used electronic health records to track whether these children were diagnosed with autism, along with factors like the mother’s pre-pregnancy weight and whether she had been diagnosed with diabetes before or during her pregnancy. Though previous research has looked at the roles of maternal obesity and diabetes on autism risk, this study is the first to examine both the independent and combined effects of the two. The researchers found that of the nearly 3,000 children in the study, about 100 were identified as on the autism spectrum. They also concluded that obese women who contracted diabetes while pregnant — a condition known as gestational diabetes — were about three times as likely to have children with autism. Women who were obese and had diabetes before pregnancy were almost four times as likely. In addition, children with autism were more often boys, more often born before 32 weeks and more often had very low birth weight. Beyond being obese and diabetic, their mothers were also more likely to be older. Having just one of the conditions, however, posed only a slight risk increase Continue reading >>

Autism Risk And Maternal Diabetes With Obesity: What You Need To Know

Autism Risk And Maternal Diabetes With Obesity: What You Need To Know

Our experts provide perspective on new research linking diabetes and obesity during pregnancy with increased risk of autism In today’s Pediatrics, researchers at Johns Hopkins Bloomberg School of Public Health report that they found a three- to four-fold higher rate of autism among children born to women who were both diabetic and obese during pregnancy. The findings raise many questions and concerns. To provide perspective, we talked with epidemiologist Michael Rosanoff and developmental pediatrician Paul Wang. Dr. Wang is Autism Speaks’ senior vice president for medical research. Mr. Rosanoff is Autism Speaks’ director for public health research. Q: Too often, this type of finding is taken as implying parents are somehow to blame for their children’s autism. Why would you urge against such an interpretation? Michael Rosanoff: Autism is a complex condition caused by a combination of environmental and genetic factors. By environmental, researchers mean a broad range of nongenetic influences including maternal health and conditions in the womb. No one environmental factor causes autism by itself. So when we say an environmental factor increases the risk of autism, we are not saying that it causes autism. In other words, not all moms who are both diabetic and obese will have a child with autism. In fact, the vast majority will not. Paul Wang: We welcome research that helps us identify some of the factors that increase the risk that autism will develop. But as Michael suggests, the vast majority of children exposed to these risk factors do not develop autism. Except in rare cases, it's not possible to say exactly why a particular child has the condition. Parents certainly shouldn’t blame themselves when the scientific understanding is so nebulous – and when so Continue reading >>

Can Early Control Of Gestational Diabetes Reduce Autism Risk?

Can Early Control Of Gestational Diabetes Reduce Autism Risk?

New study advances understanding of when and how diabetes in pregnancy contributes to autism; implications for prenatal care Diabetes that develops early in pregnancy increases the risk of autism by 40 percent, according to a large new study of more than 320,000 children and their mothers. The increased risk may stem from the effects of uncontrolled high blood sugar during a critical window of early brain development, the investigators suggest. Their report appears today in the Journal of the American Medical Association (JAMA). “While the increased risk of autism in this study is modest, the findings add to the growing body of research showing that pregnancy is particularly sensitive period for children’s brain development,” comments epidemiologist Michael Rosanoff, Autism Speaks director for public health research. To provide perspective, the increased autism risk seen with early gestational diabetes translated into roughly seven additional cases per 1,000 pregnancies. “Rather than spark anxiety, the findings should underscore the importance of comprehensive prenatal care and monitoring for the health of a woman and her baby,” adds developmental pediatrician Paul Wang, Autism Speaks head of medical research. Autism Speaks was not involved in the study, which was led by investigators at Kaiser Permanente and the University of California-Los Angeles Keck School of Medicine. What’s the difference between increasing risk versus causing autism? Read this insightful answer by pediatric neurologist and autism expert Martha Herbert. What we know about gestational diabetes Gestational diabetes develops in 6 to 7 percent of pregnancies, usually during the last trimester. It often produces no symptoms. So it can easily go unnoticed unless a woman is getting regular p Continue reading >>

Association Of Maternal Diabetes With Autism In Offspring

Association Of Maternal Diabetes With Autism In Offspring

To the Editor On behalf of the coauthors of the study “Association of Maternal Diabetes With Autism in Offspring” by Xiang et al,1 I write to explain errors that recently came to our attention. We are currently conducting additional analyses on the primary data set used in the study. In the course of those analyses, we discovered that maternal preexisting diabetes by International Classification of Diseases, Ninth Revision codes had accidentally been included as one condition in defining maternal history of comorbidity. This maternal history of comorbidity was a covariate that was included in the adjusted analyses to assess the relationship between maternal gestational diabetes mellitus and preexisting maternal diabetes and the risk of autism spectrum disorders (ASD) in offspring. Continue reading >>

Gestational Diabetes Increases Autism Risk

Gestational Diabetes Increases Autism Risk

Children are slightly more likely to develop autism if their mothers were diagnosed with diabetes early in pregnancy, a new study shows. Women newly diagnosed with diabetes by the 26th week of pregnancy were 42% more likely to have a child diagnosed with autism, according to the study of more than 322,000 children born between 1995 and 2009. Overall, about 1% of all children in the study were diagnosed with autism by a median age of age 5½. Having gestational diabetes, the kind diagnosed during pregnancy, increased the chance of having a child with autism to 1.4%. Researchers found no increase in autism risk if mothers were diagnosed with diabetes after 26 weeks of pregnancy. A typical pregnancy lasts 40 weeks. Authors also found no increased risk of autism if women had type 2 diabetes before becoming pregnant, possibly because these women already had their blood sugar under control, according to the study, published in the Journal of the American Medical Association. Diabetes interferes with the body's ability to move the sugar provided by food into cells. That can lead the levels of sugar in the blood to rise to unhealthy levels, damaging blood vessels. Anny Xiang of the Kaiser Permanente Southern California Department of Research & Evaluation says the study doesn't reveal why developing diabetes in pregnancy increases the risk of autism. It's possible that high blood sugar levels have long-lasting effects on a fetus' organ development and function, says Xiang, the study's lead author. Gestational diabetes increases a number of risks for a fetus, including death, says Susan Levy, an associate professor of pediatrics at Center for Autism Research at Children's Hospital of Philadelphia, who was not involved with the study. The new study adds to a growing body of resear Continue reading >>

Study Finds Potential Link Between Gestational Diabetes And Autism

Study Finds Potential Link Between Gestational Diabetes And Autism

Expectant mothers concerned about the risk of autism in their unborn child have something new to worry about. According to a new study of more than 320,000 children, intrauterine exposure to gestational diabetes may be associated with an increased risk of autism spectrum disorders. The study was recently published in JAMA. According to Anny H. Xiang, Ph.D., of Kaiser Permanente Southern California in Pasadena, she and her colleagues analyzed data from a single healthcare system in order to study the link between maternal diabetes and the risk of children developing autism. The study group included woman who were known to be diabetic prior to pregnancy and those who were diagnosed during pregnancy. Xiang was careful to note that the discovery of a link does not mean that gestational diabetes causes autism in children. What’s more, since there’s no magic pill to prevent autism, she suggests, “Women should see their doctor to make sure that blood sugar is normal when planning for pregnancy and throughout pregnancy.” Xiang, an adjunct research associate professor at the University of Southern California’s Keck School of Medicine, said the study included 322,323 children born between 1995 and 2009 at Kaiser Permanente Southern California hospitals. The researchers adjusted for other factors, such as maternal age, household income, race/ethnicity, and the child’s gender. Get the Facts: What Is Autism? » The researchers found no link to a risk of autism when the mothers had pre-existing type 2 diabetes. The increased risk was independent of smoking, pre-pregnancy body mass index, and gestational weight gain. The specifics of the study revealed that 6,496 children (2 percent) were exposed to pre-existing type 2 diabetes; 25,035 (8 percent) were exposed to gestation Continue reading >>

Medicated Gestational Diabetes May Up Risk For Autistic Child

Medicated Gestational Diabetes May Up Risk For Autistic Child

Medicated Gestational Diabetes May Up Risk for Autistic Child VIENNA Toddlers whose mothers had gestational diabetes mellitus that required medication were more likely to be diagnosed with autism spectrum disorder compared with other children, in a new study of Californian women. But while this is an interesting observation, it is still too early to draw any inferences, experts warn. In this cohort, the incidence of autism was 2.75/1000 per year for children whose mothers had gestational diabetes requiring medication vs 1.96/1000 per year for children whose mothers had diabetes and who did not take medical therapy and 1.77/1000 per year for children whose mothers were free of diabetes. "Clearly, the children who are exposed to gestational diabetes mellitus requiring medication have an elevated risk of autism spectrum disorder," said lead author Anny H. Xiang, PhD, from Kaiser Permanente Southern California, presenting these findings at the European Association for the Study of Diabetes 2014 Meeting earlier this month. Women with gestational diabetes requiring medication were more likely to be diagnosed with this condition earlier in the pregnancy (at 22.9 weeks vs 26.9 weeks of gestation), Dr. Xiang noted. Exposure to glucose at this earlier critical time for fetal brain development may partly explain the heightened risk of autism, she speculated. However, these findings would need to be replicated and confirmed in other populations, session cochair Elisabeth R. Mathiesen, MD, from the Denmark Center for Pregnant Women with Diabetes, Copenhagen, told Medscape Medical News after the presentation. "I find it very interesting that there might be some mental-[health] changes in the children of women who get diabetes, but we still certainly need more studies to say whether Continue reading >>

Gestational Diabetes May Be Tied To Autism In Children

Gestational Diabetes May Be Tied To Autism In Children

Women who develop gestational diabetes early in their pregnancy have a higher chance of having a child with autism than women who don't develop the condition, a new study suggests. Researchers found that mothers-to-be who developed gestational diabetes — high blood sugar during pregnancy in women who have never had diabetes — by their 26th week of pregnancy were 63 percent more likely to have a child diagnosed with an autism spectrum disorder (ASD) compared with women who did not have gestational diabetes at any point during their pregnancy (and who also did not have type 2 diabetes prior to pregnancy). The finding does not mean that autism is common among children born to women who had gestational diabetes. "Autism is still rare," said study co-author Anny Xiang, a research scientist at Kaiser Permanente Southern California in Pasadena. The findings show that, although the risk of having a child with autism is still low among women who have gestational diabetes early in pregnancy (before 26 weeks), the study did find a relationship between these women and an increased risk that the child would have autism, Xiang said. [7 Ways Pregnant Women Affect Babies] The study, published today (April 14) in the Journal of the American Medical Association, looked at more than 320,000 children born in Southern California between 1995 and 2009. About 8 percent of the kids were born to mothers who had pregnancy-related diabetes, and 2 percent had mothers with type 2 diabetes. During an average follow-up period of 5.5 years, nearly 3,400 children in the study were diagnosed with an ASD, including such conditions as autistic disorder and Asperger syndrome that can cause social, communication and behavioral problems in children. After the researchers considered other factors that can Continue reading >>

Maternal Gestational Diabetes Linked To Autism Risk For Offspring

Maternal Gestational Diabetes Linked To Autism Risk For Offspring

A team of researchers states that intrauterine exposure to gestational diabetes mellitus is associated with an increased risk of autism spectrum disorders. However, the children of mothers who had pre-existing type 2 diabetes did not have an increased risk of developing autism spectrum disorders (ASD), according to the study published in JAMA. Gestational diabetes mellitus (GDM) is a condition whereby a mother's glucose tolerance is impaired with onset or first recognition during pregnancy. According to a study conducted by the Centers for Disease Control and Prevention (CDC) from 2007-10, GDM prevalence in the US is as high as 9.2%. Previous research has identified a number of health risks for children born to mothers with GDM, including significantly larger than average birth weight (fetal macrosomia), low blood sugar levels at birth (neonatal hypoglycemia) and an increased risk of developing impaired glucose tolerance. Long-term, studies have also suggested that the exposure of fetuses to maternal hyperglycemia - in mothers with pre-existing diabetes and mothers developing GDM - could result in a long-term risk of obesity and other related metabolic disorders. "Meta-analyses have shown some evidence of a significant association between exposure to maternal diabetes and risk of ASD in offspring," write the authors. "Less information is available on the association of exposure to maternal GDM [...] with risk of ASD." For the study, Anny H. Xiang of Kaiser Permanente Southern California (KPSC) in Pasadena and colleagues analyzed the prevalence of ASD among 322,323 children born between 1995 and 2009 at KPSC hospitals. The researchers tracked the children retrospectively from birth until the date of clinical ASD diagnosis, last date of KPSC health plan membership, death Continue reading >>

Maternal Diabetes And The Risk Of Autism Spectrum Disorders In The Offspring: A Systematic Review And Meta-analysis

Maternal Diabetes And The Risk Of Autism Spectrum Disorders In The Offspring: A Systematic Review And Meta-analysis

Go to: Methods We followed the guidelines in the meta-analysis of observational studies in epidemiology (MOOSE) statement (Stroup et al. 2000) when conducting this study. The study protocol was prospectively registered in an international prospective register of systematic reviews (PROSPERO, as CRD42012003373. Literature Search and Study Selection A systematic literature search was performed in the MEDLINE/PubMed, EMBASE and PsycINFO databases through February 3rd, 2013, using a combination of free text and subheadings terms. Details of the search terms were shown in the Supplementary Text. In addition, the references listed in any relevant articles were screened. No language restriction was applied for searching or study inclusion. A published article was included if it had a case–control or cohort study design, evaluated the association between maternal diabetes and the risk of offspring ASD, and reported the risk estimates [relative risk (RR), or odds ratio (OR)] and corresponding 95 % confidence intervals (CIs) or standard errors, or provided sufficient data to calculate the risk estimates. Maternal diabetes herein includes GDM, pre-existing T1DM, and pre-existing T2DM. During the screening steps, several types of articles were excluded: review articles, editorials, or comments; studies on animals or cell lines; studies that did not evaluate maternal diabetes as exposure; and studies that did not include offspring ASD as the outcome. In addition, studies that did not report risk estimates or 95 % CIs for the relationships between maternal diabetes and risk of offspring ASD were excluded. The process of study selection is depicted in Fig. 1. Data Extraction and Quality Assessment Two investigators independently evaluated methodological quality in each study and ext Continue reading >>

Gestational Diabetes Is Linked To Autism Risk

Gestational Diabetes Is Linked To Autism Risk

Shutterstock / Poznyakov A new study of more than 320,000 babies links autism to gestational diabetes. The longitudinal study, conducted between 1995 and 2009 by researchers at Kaiser Permanente Southern California, found that children born to mothers who developed gestational diabetes before 26 weeks of pregnancy were at a 63 percent increased risk of being diagnosed with autism spectrum disorder. But after controlling for maternal age, education, ethnicity, household income, the child’s sex and the mother’s pre-existing conditions, that risk dropped to 42 percent. While the overall rate of autism among study participants was 1 in 100 (mirroring national averages during the period of study), the rate of autism among children born to mothers with early pregnancy diabetes was 1 in 80. Because this is a longitudinal association study, researchers were not able to establish a cause for the autism diagnosis. However, the associations were strong enough to warrant at least two health applications for expectant parents, according to study co-author Dr. Edward Curry. For one, the study’s results emphasize the importance of early prenatal care. The women whose children were most at risk for developing autism were not women with previously diagnosed type 2 diabetes (who were already managing the condition with insulin, medication and diet). Nor were they women who got gestational diabetes after 26 weeks. Instead, the link between early gestational diabetes and an increased likelihood of autism diagnosis could mean that a fetus’ early exposure to uncontrolled high blood sugar may somehow affect brain development. “We want to get mothers in early to make sure they’re on their vitamins, folic acid and that they check blood sugar to make sure it’s under control early o Continue reading >>

Obesity, Diabetes During Pregnancy Linked To Autism

Obesity, Diabetes During Pregnancy Linked To Autism

Mothers-to-be who are both obese and diabetic have a higher risk of giving birth to a child with autism than healthy women, a new study suggests. The two conditions in combination nearly quadrupled the risk that a child would receive an autism diagnosis, said researchers who looked at more than 2,700 mother-child pairs. Individually, maternal obesity or diabetes was linked to twice the odds of giving birth to a child with autism compared to mothers of normal weight without diabetes, the study found. "The finding is not a total surprise," said study author Dr. Xiaobin Wang, director of the Center on Early Life Origins of Disease at Johns Hopkins University in Baltimore. "Many studies have shown that maternal obesity and diabetes have an adverse impact on developing fetuses and their long-term metabolic health." "Now we have further evidence that maternal obesity and diabetes also impact the long-term neural development of their children," added Wang. The study doesn't prove that obesity and diabetes in tandem actually cause the autism, however. It only found an association. The study, which tracked more than 2,700 births, adds to evidence that autism risk may start before birth, the researchers said. In the United States, more than one-third of women of reproductive age are obese, while almost 10 percent struggle with diabetes, the study authors said in background notes. Prevalence of autism -- now affecting 1 in 68 U.S. kids -- has skyrocketed since the 1960s, alongside the incidence of obesity and diabetes in women of reproductive age, the authors point out. Their study, published online Jan. 29 in the journal Pediatrics, involved children born at Boston Medical Center between 1998 and 2014. All the babies' mothers were interviewed one to three days following delivery, Continue reading >>

Mom’s Obesity, Diabetes Linked With Autism And Developmental Delays

Mom’s Obesity, Diabetes Linked With Autism And Developmental Delays

April is National Autism Awareness Month, and it’s been marked by a steady stream of research about the causes of the disorder — including complex genetic factors and the risk from older fathers — and its characteristics, such as the finding that it now affects 1 in 88 children, but that 10% of affected children may outgrow their diagnosis by the time they hit their teens. Now another study is raising a particularly intriguing theory, given the expanding girth of the U.S. population: that mothers who are obese or have diabetes during pregnancy — these conditions can often go hand in hand — see higher rates of autism in their children. Researchers at the University of California, Davis, looked at 1,004 children aged 2 to 5 years enrolled in the CHARGE (Childhood Autism Risks from Genetics and the Environment) study from 2003 to 2010. The study included 517 children with autism spectrum disorders, 172 with other developmental disorders, and 315 who were typically developing. (MORE: Q&A: Losing Weight Doesn’t Help Obese Girls Love Themselves — Can Parents?) Obese mothers were 67% more likely than mothers of normal weight and with no metabolic disorders to have a child with autism, and they were more than twice as likely to have a child with another developmental disorder — a delay in speech delay, perhaps, or a failure to reach developmental milestones at the appropriate age, according to the study published Monday in Pediatrics. Moms of children who were not developing typically were more likely to be obese: 21.5% of mothers of children with autism and 23.8% of mothers of children with developmental delays were obese, versus 14.3% of moms of typically developing children. Mothers with diabetes were 2.3 times more likely to have a child with developmental d Continue reading >>

Gestational Diabetes: A Risk Factor For Autism?

Gestational Diabetes: A Risk Factor For Autism?

With commentary by Alycia Halladay, PhD, chief science officer of the Autism Science Foundation Women who develop gestational diabetes early in their pregnancy have a slightly higher risk of having a child diagnosed with autism, according to a new study published in the Journal of the American Medical Association (JAMA). The large-scale study of more than 322,000 children, found that women diagnosed with diabetes by the 26th week of pregnancy were 42 percent more likely to have a child with autism. The risk is still very small, but significant, rising from a 1 percent risk (in this study) to a 1.4 percent risk. “Children born to mothers with gestational diabetes are at risk for diabetes themselves, obesity, and through this evidence, autism,” says Alycia Halladay, PhD, chief science officer of the Autism Science Foundation. The study did not find an increased risk of autism for babies born to women who were already diagnosed with diabetes before getting pregnant. This might be in part because women with diabetes who become pregnant have made lifestyle modifications that keep their sugar levels in check and may also be taking medications to control their blood sugar. Similarly, those diagnosed with gestational diabetes after 26 weeks (the third trimester) did not have an increased risk. The study authors speculated that being exposed to untreated high blood sugar during critical brain development early in the pregnancy may have contributed to the autism risk. “The authors suggest it could be the result of direct damage to the developing brain because of too much glucose or inflammation, which have already been associated with autism,” says Halladay. Combatting the risk Taking care to manage gestational diabetes by working closely with your obstetrician and other Continue reading >>

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