Autistic Disorder In Children Research Articles

Association between heavy metals exposure (cadmium, lead, arsenic, mercury) and child autistic disorder: a systematic review and meta-analysis.

Studies have found that toxic heavy metals exposure could induce the generation of reactive oxygen species (ROS), and is of epigenetic effect, which might be associated with the occurrence of Autistic Disorder (ASD). This systematic review and meta-analysis aims to elucidate the association between exposure to 4 heavy metals, cadmium (Cd), lead (Pb), arsenic(As), and mercury (Hg), and the occurrence of ASD in children. We searched PubMed, Web of Science, Embase, and Cochrane Library, from their inception to October 2022, for epidemiological investigations that explore the association between exposure to Cd, Pb, As, or Hg and the occurrence of child ASD. A total of 53 studies were included, involving 5,054 individuals aged less than 18 (2,533 ASD patients and 2,521 healthy controls). Compared with the healthy controls, in hair and blood tests, concentrations of the 4 heavy metals were significantly higher in the ASD group than in the healthy control group, and the differences in Pb, arsenic and Hg were statistically significant (P < 0.05). In the urine test, concentrations of arsenic and Hg were significantly higher in the ASD group than in the healthy control group (P < 0.05), while the results of Cd and Pb were opposite to those of arsenic and Hg (P > 0.05). Subgroup analysis for geographic regions showed that ASD patients in Asia and Europe had higher concentrations of the 4 heavy metals, compared with the healthy controls, in which the differences in Pb, arsenic, and Hg were statistically significant (P < 0.05), while in North America, the healthy controls had higher Cd, arsenic, and Hg concentrations (P > 0.05). Compared with the healthy control group, the ASD group had higher concentrations of Cd, Pb, arsenic, and Hg. These 4 heavy metals play different roles in the occurrence and progression of ASD. Moreover, there is significant heterogeneity among the included studies due to controversies about the study results among different countries and regions and different sources of detection materials. The results of this study firmly support the policies to limit heavy metals exposure, especially among pregnant women and young children, so as to help reduce the incidence of ASD.

Systemic Cryotherapy in the Treatment of Autistic Children

Aim: Autistic disorders in children cover three developmental areas: social interaction, communication development disorders, and repetitive behavioral repertoire. Autistic children are a group resistant to therapeutic intervention due to their imapired contact with the environment, but the correction and compensation of disturbed functions through the interaction of motor and seems to be the most important goal of therapy. Materials and Methods: The study group consisted of 57 students of two special schools diagnosed with autism (age 6-16 (AVG 10 +/- 6), whose parents consented to participate in the research program, this 12 (21%) girls and 45 (79) %) boys. Fine and gross motor skills were assessed. The assessment of fine motoricity included the evaluation of the functions of individual parts of the body: throwing and catching a large ball, throwing tennis balls accurately into the basket while sitting on a chair, standing, lying on a mattress, pedalling on a stationary bike, performing unassisted squats, lifting the knees high in a standing position,unassisted jumping on a baton and kicking a volleyball. Large motor activity (change of place) included: walking up the stairs holding on to the handrail, stepping back and forth,going through the tunnel, walking on a ramp inclined at an angle of 45, traversing an obstacle course made of soft rollers of different sizes with the help of another person. After a two-week break, the subjects received a series of 10 treatments temperature at a temperature of - 110°C, each treatment lasting 2 minutes. The treatments took place once a day from Monday to Friday, excluding Saturdays and Sundays. After each treatment, the patient exercised for 1 hour in accordance with the previous results of fine and gross motor skills. Results: 1 child (10 entries) completed a full series of treatments. Other children: - 9 entries - 1 child, - 8 entries - 2 children, - 4 entrances – 2 children, - 3 entries - 1 child, - 2 children refused to continue the procedure after 30 seconds, - 2 child refused to enter the cryochamber. Conclusions: 1. It seems that cryogenic therapy should not be used in autistic children due to safety and the amount of work involved in preparing and conducting the procedures. 2. Parents’ attitudes towards the disease and their child’s treatment options make it difficult to cooperate and plan the therapy.3. In adult high-functioning autistics being treated at ZUL there is a very good tolerance of the procedure.

Фармакологічні властивості препаратів цинку

The review represents data about biochemical and physiological zinc properties, its pharmacological influence. Among the trace elements, zinc is one of the most used elements in biology and medicine. Zinc preserves molecular integration, influences the growth and division of cells, is included in some enzymes. Metallothioneins bind zinc with high affinity and serve as intracellular zinc reservoir. They may release free intracellular zinc when needed and mediate physiological zinc role, maintain zinc homeostasis in brain synaptic activity. Metallothioneins are strong radical scavengers that is why zinc plays the main role in oxidative stress. It is intracellular regulator, which influences apoptosis, osteogenesis, keratogenesis, provides intracellular support to proteins during molecular integration. It is a structural component in nucleonic acids and gene regulator proteins. Zinc deficiency has been detected in neurological and psychic diseases. Zinc supplement was effective in patients with stroke and brain injury. Zinc has a positive impact on memory and reduces hyperactivity in children. Zinc is involved in signals neurotransmission. Its deficiency in brain is connected with Alzheimer`s disease, depression, schizophrenia that is why it is used for the treatment of these diseases. Vitamin C is the zinc synergist in the treatment of neurological and psychic diseases as it has antioxidant properties, takes place in detoxication. Zinc plays the important role in autistic disorders in children and is included in the pharmacotherapy of this status. Zinc deficiency leads to liver diseases, hepatitis, liver cirrhosis and gastrointestinal disturbances such as appetite loss, diarrhea, and anorexia. In chronic liver diseases, zinc corrects amino acids disbalance, capacity to synthesize albumin, metabolize ammonium. It was shown that zinc as a heavy metal has antimicrobial action in diarrheas, cholera and other gastrointestinal diseases. It was detected that zinc has antiviral effects in herpes diseases and diseases of upper respiratory ways. Conclusion. Zinc deficiency is connected with some autoimmune diseases such as asthma, eczema and other dermatological diseases. The supply of human organism with zinc and vitamins A, C, D and E is a promising approach because it is a cofactor of 118 proteins aimed at antiviral protection of the human body including interferon-1-dependent proteins against coronavirus. It was shown that zinc helps to inhibit «cytokine storm» characteristic of COVID-19, reduces chronic systemic inflammation and compensates for comorbid pathologies of cardiovascular system in patients with COVID-19. Zinc may influence other systems such as reproductive function, pregnancy, fetus, testosterone synthesis

New therapeutic agents marketed in 2020: Part 2

New therapeutic agents marketed in 2020: Part 2

The knowledge of the nursing team about autistic disorders in children in the light of the human caring theory

Introduction: Autistic Spectrum Disorders (ASD) or Autistic Disorders (AD) are complex neurodevelopmental disorders characterized by social communication deficits, social interaction, and nonverbal behavior in multiple contexts. Objective: To analyze the knowledge of the nursing team about ASD and the approach to the subject during professional training based on the principles addressed in the Human Caring Theory. Methods: Descriptive study with a qualitative approach, adopting the Human Caring Theory by Jean Watson as a theoretical reference. Ten semi-structured interviews were conducted with professionals from the nursing team of a Primary Health Center in the ABC Region from São Paulo State, Brazil, in May 2019. Their knowledge about ASD in children was assessed by a 7-question guiding script. Data analysis was performed using Content Analysis Method. Results: Four main categories were elaborated: the care based on humanistic-altruistic values, the cultivation of sensitivity for self and the other, the valorization of the feelings expression and the interpersonal relationship, the promotion of intra and interpersonal teaching-learning process. Conclusion: The nursing team professionals are not prepared to work in the care of children with ASD. During their training, the subject's approach is poor, making professionals feel insecure and unable to provide care to this child and his family.

THE DESIGN OF EXPERT SYSTEM APPLICATION FOR DIAGNOSING AUTISM DISORDERS IN CHILDREN

The level of public understanding of autistic disorders and how to handle them that still lacking is the main reason in this study. How to know that a child has an autistic disorder or not is generally done by manual and simple way, it done by filling out a checklist or questionnaire that contains facts, attitudes and behaviors that often appear in children. The checklist is filled by parents who will then be observed again by the therapist to get clear, accurate, and reliable results. The weakness from this method in diagnosing there is an autistic disorder or not is it must involve therapists/experts who are currently still few in number.&#x0D; The purpose of this study is to make a software namely an expert system application that able to diagnose autistic disorders in children that are tailored to the needs of parents. The results of this study are a series of product design systems for expert systems to diagnose autistic disorders in children including ongoing system flowcharts, computerized system flowcharts, Data Flow Diagrams, application program flowcharts and display of application programs that have been built. The results of designing expert system software applications are expected to be used by therapists in diagnosing children who come to consult

Combination of atomic force microscopy and mass spectrometry for the detection of target protein in the serum samples of children with autism spectrum disorders

Possibility of detection of target proteins associated with development of autistic disorders in children with use of combined atomic force microscopy and mass spectrometry (AFM/MS) method is demonstrated. The proposed method is based on the combination of affine enrichment of proteins from biological samples and visualization of these proteins by AFM and MS analysis with quantitative detection of target proteins.

Visual impairment and traits of autism in children.

Visual impairment present from birth or from an early childhood may lead to psychosocial and emotional disorders. 11-40% of children in the group with visual impairment show traits of autism. The aim of this paper was to present the selected examples of how visual impairment in children is related to the occurrence of autism and to describe the available tools for diagnosing autism in children with visual impairment. So far the relation between visual impairment in children and autism has not been sufficiently confirmed. Psychiatric and psychological diagnosis of children with visual impairment has some difficulties in differentiating between "blindism" and traits typical for autism resulting from a lack of standardized diagnostic tools used to diagnosing children with visual impairment. Another difficulty in diagnosing autism in children with visual impairment is the coexistence of other disabilities in case of most children with vision impairment. Additionally, apart from difficulties in diagnosing autistic disorders in children with eye dysfunctions there is also a question of what tools should be used in therapy and rehabilitation of patients.

Stressful life events during pregnancy as risk factors for developing autistic disorder in children

Introduction: This study aimed to examine the role of prenatal stressful events in mothers of children and adolescents with autistic disorder (AD). Methods: This case-control study was conducted in 2014. A total number of 115 children and adolescents with AD were selected by convenience method from the autism rehabilitation centers in Tabriz, Iran. Moreover, 112 typically developing (TD) children and adolescents were selected from public schools using a random clustering method. Two groups were matched in terms of mother's and child's age and mother's educational level. The Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) semi-structured diagnostic interview was used to evaluate the presence of psychiatric disorders. The diagnosis of AD was made based on the DSM-IV criteria during separate diagnostic interviews by two child and adolescent psychiatrists. The life stressful events’ inventory was used to assess the presence of stressful events during pregnancy. Results: According to Fisher's exact test, the frequency of stressful life events including failure to achieve life goals, high debt, frequent marital conflict, conflict with spouse's family, changes in sleeping habits, and sexual difficulties in the mothers of AD children during pregnancy was significantly higher than the mothers of TD children. Also, mothers of AD children reported significantly higher frequency for the positive stressful life events including the major job progress, starting or finishing education, change of education, location, and summer vacation during pregnancy. Conclusion: Some stressful life events in mothers during pregnancy may be considered as risk factors for developing AD in their children. Further researches are needed to establish the results of this study.

Problems of the Diagnosis and Correction of Autism in Children (using Asperger’s syndrome as an example)

We present here the generalized characteristics of diagnostic difficulties in relation to early autistic disorders in children, along with the main differential diagnostic signs allowing mild forms of infantile autism diagnosed as Asperger’s syndrome to be distinguished from infantile schizophrenia, residual organic CNS damage, and cyclic affective disorders. Cases of Asperger’s syndrome followed clinically for many years are described and recommendations are given for social-psychological adaptation of children and adolescents with Asperger’s syndrome at different ages.

The association between the interpregnancy interval and autism spectrum disorder in a Canadian cohort.

Two studies reported an increased risk of autistic disorder in children conceived less than 12 months after a previous birth. Our objective was to examine the association between the interpregnancy interval (IPI) and autism spectrum disorder (ASD) in a Canadian cohort. Using administrative datasets housed at the Manitoba Centre for Health Policy, we identified pairs of first- and second-born singleton siblings born between 1988 and 2005. Diagnoses of ASD were ascertained by searching physician billing claims, hospital discharge abstracts, education data, and a database containing information on individuals identified for a 2002-2007 ASD surveillance program in Manitoba. Logistic regression models were fit to examine the association between the IPI and ASD in 41,050 second-born siblings where the first-borns did not have ASD, using IPIs of ≥ 36 months as the reference category and specifying three case groups. Case Group 1 included individuals with at least one ASD code (n = 490); Case Group 2 included those with two or more ASD codes (n = 375); and Case Group 3 comprised individuals with a record in the ASD surveillance program database (n = 141). The adjusted odds ratios (ORs) for IPIs shorter than 12 months ranged from 1.22 (95% CI: 0.91-1.63) for Case Group 1 to 1.72 (95% CI: 0.96-3.06) for Case Group 3. When the case groups were restricted to individuals with more severe ASD, the ORs increased and were significant for Case Groups 1 and 2. Our findings also support an association between short IPIs and more severe ASD.

O-060 Assessing Autism In Toddlers Born

The Autism Diagnostic Observation Schedule (ADOS) is the only available semi-structured observational assessment of autism and has not been used extensively in preterm toddlers. We used a screening and diagnostic method to determine the diagnostic prevalence of autism and the characteristics of screen positive cases. <h3>Methods</h3> A 12-month birth-cohort of toddlers (2-and-4-years-old) born with a gestational age &lt;29-weeks were administered the Modified Checklist of Autism in Toddlers (M-CHAT)-and follow-up interview (FI™) screen, the ADOS and neurodevelopmental assessments (Bayley Scales of Infant and Toddler Development III-2-year-olds, Wechsler Preschool and Primary Scale of Intelligence-III and Adaptive Behaviour Assessment System-Second Edition-4-year-olds). The ADOS was conducted on toddlers with M-CHAT-FI™ positive screens. <h3>Results</h3> Complete data were available on 88% (169/192) of children. Thirteen-percent screened M-CHAT-FI™ positive. ADOS (DSM-IV-criteria) classified 1.8% with autistic disorder and none with ASD. Multivariate analysis showed that social emotional delay (p = &lt;0.001) was the only neurodevelopmental factor independently associated with M-CHAT-FI™ positive screens even after adjusting for psychosocial risk and child gender. All but one of the M-CHAT-FI™ positive screens scored some level of abnormality at the domain and item level on the ADOS testing, one third of these reached the Communication Total category cut off for ASD for the combined Communication and Social Interaction Total Score. Four children displayed comorbid atypical development (DQ/IQ &lt;-2SD). <h3>Conclusion</h3> The ADOS reports a lower incidence of autistic disorder in children born very preterm compared to studies using diagnostic interview based tools. The distinguishing features of the M-CHAT-FI™ positive cases suggest a sub-threshold communication dysfunction profile.

Effects of Risperidone on Core Symptoms of Autistic Disorder Based on Childhood Autism Rating Scale: An Open Label Study

Background:The aim of the present study was to evaluate the effect of risperidone in patients afflicted by autistic disorder especially with regards to its three core symptoms, including “relating to others”, “communication skills”, and “stereotyped behaviors” based on Childhood Autism Rating Scale (CARS).Materials and Methods:An 8-week open-label study of risperidone for treatment of autistic disorder in children 4-17 years old was designed. Risperidone dose titration was as follow: 0.02 mg/kg/day at the first week, 0.04 mg/kg/day at the second week, and 0.06 mg/kg/day at the third week and thereafter. The outcome measures were scores obtained by CARS, Aberrant Behavior Checklist (ABC), and Clinical Global Impression-Improvement (CGI-I) scale.Results:Fifteen patients completed this study. After 8 weeks, CARS total score decreased significantly, (P=0.001). At the end of the study, social interactions and verbal communication skills of the patients were significantly improved (P<0.001, P=0.03, respectively). However, stereotypic behaviors did not show any significant change in this study. Increase in appetite and somnolence were the most reported side effects.Conclusion:This study suggests that risperidone may be an effective treatment for the management of core symptoms of autistic disorder.

Interpregnancy Interval and Risk of Autistic Disorder

A recent California study reported increased risk of autistic disorder in children conceived within a year after the birth of a sibling. We assessed the association between interpregnancy interval and risk of autistic disorder using nationwide registry data on pairs of singleton full siblings born in Norway. We defined interpregnancy interval as the time from birth of the first-born child to conception of the second-born child in a sibship. The outcome of interest was autistic disorder in the second-born child. Analyses were restricted to sibships in which the second-born child was born in 1990-2004. Odds ratios (ORs) were estimated by fitting ordinary logistic models and logistic generalized additive models. The study sample included 223,476 singleton full-sibling pairs. In sibships with interpregnancy intervals <9 months, 0.25% of the second-born children had autistic disorder, compared with 0.13% in the reference category (≥ 36 months). For interpregnancy intervals shorter than 9 months, the adjusted OR of autistic disorder in the second-born child was 2.18 (95% confidence interval 1.42-3.26). The risk of autistic disorder in the second-born child was also increased for interpregnancy intervals of 9-11 months in the adjusted analysis (OR = 1.71 [95% CI = 1.07-2.64]). Consistent with a previous report from California, interpregnancy intervals shorter than 1 year were associated with increased risk of autistic disorder in the second-born child. A possible explanation is depletion of micronutrients in mothers with closely spaced pregnancies.

Maternal prenatal folic acid supplementation is associated with a reduction in development of autistic disorder

Suren P, Roth C, Bresnahan M, Haugen M, Hornig M, Hirtz D, et al. Association between maternal use of folic acid supplements and risk of autism spectrum disorders in children. JAMA. 2013;309:570-77. Question What is the association of prenatal folic acid supplementation in pregnant women with subsequent development of autism spectrum disorders (ASDs; autistic disorder, Asperger syndrome, pervasive developmental disorder–not otherwise specified [PDD-NOS]) in their children? Design Population-based, prospective Norwegian Mother and Child Cohort Study. Setting Norway. Participants 109 000 children born from 1999 to 2009 and their mothers. Intervention The exposure of primary interest was use of folic acid from 4 weeks before to 8 weeks after the start of pregnancy, defined as the first day of the last menstrual period before conception. Outcomes Specialist-confirmed diagnosis of ASD. Main Results At the end of follow-up, 270 children in the study sample had been diagnosed with ASDs: 114 with autistic disorder, 56 with Asperger syndrome, and 100 with PDD-NOS. In children whose mothers took folic acid, 0.10% (64/61 042) had autistic disorder, compared with 0.21% (50/24 134) in those unexposed to folic acid. The adjusted OR for autistic disorder in children of folic acid users was 0.61 (95% CI, 0.41–0.90). No association was found with Asperger syndrome or PDD-NOS, but power was limited. Similar analyses for prenatal fish oil supplements showed no such association with autistic disorder, even though fish oil use was associated with the same maternal characteristics as folic acid use. Conclusions Use of prenatal folic acid supplements around the time of conception was associated with a lower risk of autistic disorder in this cohort. Although these findings cannot establish causality, they do support prenatal folic acid supplementation. Commentary The report by Sureen et al utilizes the Norwegian Mother and Child Cohort Study (MoBa) Autism Birth Cohort to report that periconceptional folic acid supplementation (4 weeks before to 8 weeks after conception) lowers the risk of autistic disorder, but not other ASDs. These findings are consistent with findings from recent studies from Asia, Europe, and North America, suggesting that children of mothers with higher blood folate concentrations or mothers receiving folic acid supplements had improved neurodevelopmental outcomes.1–4 It is unclear whether these findings have clinical implications in the US. We already know that periconceptional intake of folic acid will reduce a woman’s risk of a neural tube birth defect-affected pregnancy. This knowledge has led to the existing recommendation in the US that women capable of becoming pregnant consume 400 µg/day of folic acid. This report may motivate more women to consume supplements before and during early pregnancy. Elsewhere in the world, these findings could be influential in establishing supplementation programs designed to increase folic acid intake, thus, preventing neural tube birth defects and possibly ASDs. The MoBa birth cohort has several advantages that are beneficial for examining this type of association. These include a prospective study design, collection of supplement-use data with validated instruments during pregnancy, and active screening of children for autism. In addition, the authors were able to address concerns about selection bias and unmeasured confounders that are potentially serious concerns inherent in any cohort study. To evaluate selection bias, the authors compared their results with Norway’s Medical Birth Registry and found similar results, suggesting that those women who chose to participate in MoBa were similar to women who did not participate. Unmeasured confounding could have been a problem in MoBa because women who chose to take folic acid supplements before and during early pregnancy were compared with those who did not take folic acid supplements either by choice or lack of knowledge. To assess this potential confounder, the authors replicated their folic acid supplementation analysis with fish oil supplements, assuming that fish oil supplementation would be subject to similar unmeasured confounding. They also analyzed folic acid use at 22 weeks’ gestation. Neither of these secondary analyses identified associations with ASDs, suggesting that unmeasured confounding was less likely to explain the association. The etiologies of ASDs are unknown, but are thought to be a combination of multiple genetic and environmental risk factors. Identified risk factors account for only a small portion of children with autistic disorder. The potential for folic acid to prevent autistic disorder likely will generate new avenues of research, which may yield new prevention strategies. However, these findings need to be confirmed in other population-based birth cohorts.

Maternal Folic Acid Supplementation and Risk of Autism—Reply

To the Editor: Dr Suren and colleagues reported on the decreased incidence of autistic disorder in children whose mothers received prenatal folic acid supplementation around the time of conception. The study expands on their previous report of an association between prenatal folic acid and severe childhood language delay, a key feature of autism spectrum disorders. Even though the epidemiological study design precludes a demonstration of causation, this study does suggest an association between folate metabolism and the development of autism spectrum disorders. Aberrant folatedependent metabolism and increased oxidative stress have been identified in autism spectrum disorders. Furthermore, cerebral folate receptor autoantibodies have been identified in up to three quarters of children with autism spectrum disorders. Treatment with folinic acid, a metabolically active form of folic acid, in children with autism spectrum disorders positive for folate receptor autoantibodies has led to significantly improved nonverbal communication, language, attention, and stereotypies. There is a dearth of research focusing on metabolic and immunological dysfunction in autism spectrum disorders and the neurobiological underpinnings of these disorders remain largely elusive. The combination of findings from clinical and epidemiological research should prompt heightened interest in and study of folate-related metabolic and immune processes in autism spectrum disorders.

Maternal Folic Acid Supplementation and Risk of Autism

To the Editor: Dr Suren and colleagues reported on the decreased incidence of autistic disorder in children whose mothers received prenatal folic acid supplementation around the time of conception. The study expands on their previous report of an association between prenatal folic acid and severe childhood language delay, a key feature of autism spectrum disorders. Even though the epidemiological study design precludes a demonstration of causation, this study does suggest an association between folate metabolism and the development of autism spectrum disorders. Aberrant folatedependent metabolism and increased oxidative stress have been identified in autism spectrum disorders. Furthermore, cerebral folate receptor autoantibodies have been identified in up to three quarters of children with autism spectrum disorders. Treatment with folinic acid, a metabolically active form of folic acid, in children with autism spectrum disorders positive for folate receptor autoantibodies has led to significantly improved nonverbal communication, language, attention, and stereotypies. There is a dearth of research focusing on metabolic and immunological dysfunction in autism spectrum disorders and the neurobiological underpinnings of these disorders remain largely elusive. The combination of findings from clinical and epidemiological research should prompt heightened interest in and study of folate-related metabolic and immune processes in autism spectrum disorders.

Association Between Maternal Use of Folic Acid Supplements and Risk of Autism Spectrum Disorders in Children

Importance Prenatal folic acid supplements reduce the risk of neural tube defects in children, but it has not been determined whether they protect against other neurodevelopmental disorders. Objective To examine the association between maternal use of prenatal folic acid supplements and subsequent risk of autism spectrum disorders (ASDs) (autistic disorder, Asperger syndrome, pervasive developmental disorder–not otherwise specified [PDD-NOS]) in children. Design, Setting, and Patients The study sample of 85 176 children was derived from the population-based, prospective Norwegian Mother and Child Cohort Study (MoBa). The children were born in 2002-2008; by the end of follow-up on March 31, 2012, the age range was 3.3 through 10.2 years (mean, 6.4 years). The exposure of primary interest was use of folic acid from 4 weeks before to 8 weeks after the start of pregnancy, defined as the first day of the last menstrual period before conception. Relative risks of ASDs were estimated by odds ratios (ORs) with 95% CIs in a logistic regression analysis. Analyses were adjusted for maternal education level, year of birth, and parity. Main Outcome Measure Specialist-confirmed diagnosis of ASDs. Results At the end of follow-up, 270 children in the study sample had been diagnosed with ASDs: 114 with autistic disorder, 56 with Asperger syndrome, and 100 with PDD-NOS. In children whose mothers took folic acid, 0.10% (64/61 042) had autistic disorder, compared with 0.21% (50/24 134) in those unexposed to folic acid. The adjusted OR for autistic disorder in children of folic acid users was 0.61 (95% CI, 0.41-0.90). No association was found with Asperger syndrome or PDD-NOS, but power was limited. Similar analyses for prenatal fish oil supplements showed no such association with autistic disorder, even though fish oil use was associated with the same maternal characteristics as folic acid use. Conclusions and Relevance Use of prenatal folic acid supplements around the time of conception was associated with a lower risk of autistic disorder in the MoBa cohort. Although these findings cannot establish causality, they do support prenatal folic acid supplementation.

Folate forever- all methyl group donations welcome!

Folate forever- all methyl group donations welcome!

Association Between Maternal Use of Folic Acid Supplements and Risk of Autism Spectrum Disorders in Children

Prenatal folic acid supplements reduce the risk of neural tube defects in children, but it has not been determined whether they protect against other neurodevelopmental disorders. To examine the association between maternal use of prenatal folic acid supplements and subsequent risk of autism spectrum disorders (ASDs) (autistic disorder, Asperger syndrome, pervasive developmental disorder-not otherwise specified [PDD-NOS]) in children. The study sample of 85,176 children was derived from the population-based, prospective Norwegian Mother and Child Cohort Study (MoBa). The children were born in 2002-2008; by the end of follow-up on March 31, 2012, the age range was 3.3 through 10.2 years (mean, 6.4 years). The exposure of primary interest was use of folic acid from 4 weeks before to 8 weeks after the start of pregnancy, defined as the first day of the last menstrual period before conception. Relative risks of ASDs were estimated by odds ratios (ORs) with 95% CIs in a logistic regression analysis. Analyses were adjusted for maternal education level, year of birth, and parity. Specialist-confirmed diagnosis of ASDs. At the end of follow-up, 270 children in the study sample had been diagnosed with ASDs: 114 with autistic disorder, 56 with Asperger syndrome, and 100 with PDD-NOS. In children whose mothers took folic acid, 0.10% (64/61,042) had autistic disorder, compared with 0.21% (50/24,134) in those unexposed to folic acid. The adjusted OR for autistic disorder in children of folic acid users was 0.61 (95% CI, 0.41-0.90). No association was found with Asperger syndrome or PDD-NOS, but power was limited. Similar analyses for prenatal fish oil supplements showed no such association with autistic disorder, even though fish oil use was associated with the same maternal characteristics as folic acid use. Use of prenatal folic acid supplements around the time of conception was associated with a lower risk of autistic disorder in the MoBa cohort. Although these findings cannot establish causality, they do support prenatal folic acid supplementation.