Maternal Metabolic Conditions and Risk for Autism and Other Neurodevelopmental Disorders

KEY POINTS FROM THIS ARTICLE: 1) This study looked at 1004 children: 517 with autism 172 with developmental delays 315 controls 2) Mothers with metabolic conditions (diabetes, obesity) increased theirchildrens risk of: * Autism by 61% * Developmental Delays by 135% 3) Conclusions: Maternal metabolic conditions are associated with neurodevelopmental problems in children. With obesity rising steadily, theseresults appear to raise serious public health concerns. 4) Several studies suggest that the pathogenesis of autism most likely begins inutero. 5) Obesity is linked to * Chronic inflammation * Type II diabetes * Hypertension 6) In the United States, in women of childbearing age: * 60% are overweight * 33% are obese * 16% have metabolic syndrome 7) After adjusting for covariates, mothers with diabetes were 2.3 times morelikely to have a child with Developmental Delays 8) The risk of having a child with Autism or Developmental Delays relative toTypical Development was significantly increased among obese women: * 67% for Autism * 108% for Developmental Delays 2 9) For women with any metabolic condition, the increase risk of: * Autism 61% * Developmental Delays 135% 10) In this study, diabetes, hypertension, and obesity were more commonamong mothers of children with Autism and Developmental Delays compared to controls. 11) Obesity is a significant Dental X-Rays and Risk of Meningioma risk factor for both hypertension and diabetes and is characterized by increasedinsulin resistance and chronic inflammation. 12) In a diabetic and possibly pre-diabetic pregnancy, poorly regulated maternalglucose can result in adverse fetal development. Prolonged fetal exposure toelevated glucose levels results in chronic fetal hyperinsulinemia, which in turntriggers the fetus to increase oxygen consumption and metabolism, inducingchronic intrauterine tissue hypoxia. 13) Mothers with metabolic conditions (diabetes, obesity) increase the risk of theirchildren having Autism and Developmental delays through these mechanisms: A)) Chronic hyperinsulinemia causes chronic intrauterine hypoxia: B)) Iron deficiency: Both fetal hypoxia and iron deficiency can profoundly affect neurodevelopment in humans, including alterations in myelination and cortical connectivity. Fetal iron deficiency is also linked to reduced recognition memory andbehavioral problems. C)) Increased maternal levels of the pro-inflammatory cytokine interleukin-6: Interleukin-6 will cross the placenta and disrupt normal fetal brain development. 14) Maternal obesity and diabetes may be associated with neurodevelopmentalproblems in children and therefore could have serious public health implications.