A recent study presented at the International Meeting of Autism Research (IMFAR) 2016
shows a significant association between any form of hypertension during
pregnancy, particularly in the presence of placental insufficiency and the risk
of developing ASD in the offspring.
"Children
born to women with preeclampsia, or placental insufficiency, or both are at
risk for adverse neurodevelopmental outcomes, including intellectual disability
and autism," principal investigator Cheryl Walker, MD, MIND Institute,
University of California, Davis, in Sacramento told news media.
"Identification
of these children might facilitate very early interventions and improved
developmental outcomes at a time when the brain is most responsive to
modification," she added.
The current
research is an extension of Childhood Autism Risk from Genetics and Environment
(CHARGE) study published in Published in JAMA Pediatrics in
2014.
Results of
the CHARGE study shows that children who were diagnosed with ASD were twice as
likely to be exposed to preeclampsia as compared to controls who showed a
typical development(TD).
In the
current study also conducted at University of California, Davis, the
researchers Paula Krakowiak, PhD and her colleagues decided to dig deeper and
study the effects of specific categories of hypertension with and without the
presence of placental insufficiency.
The study
subjects were drawn from large cohorts of children born in California from 1991
to 2008.
The
different types of hypertension studied were chronic hypertension,
preeclampsia, and hypertension superimposed on preeclampsia. Presence of Placental
insufficiency was determined by signs of intrauterine growth restriction,
inadequate amniotic fluid, and small-for-gestational-age birthweight.
Dr Krakowiak
opined "Women with any type of hypertensive disorder had approximately a
20% increased risk for having a child with autism relative to the general
population." While placental insufficiency alone was modestly associated
with ASD risk.
In contrast,
women with placental insufficiency and any type of preeclampsia or chronic
hypertension has almost 40% increased risks of having a child with ASD.
Association
were stronger between intellectual disabilities and preeclampsia. Women had
twofold the risk of bearing a child with intellectual disability if she has hypertension
and superimposed preeclampsia and the risk rises to threefold in placental
insufficiency alone.
Dr Krakowiak
observed that the association between hypertensive disorders and intellectual
disability was stronger than that for ASD, noting that there is overlap between
autism and intellectual disability in real life.
"Many
children with autism have varying levels of cognitive impairments, and some
children with intellectual disability have mild behavioral symptoms reminiscent
of autistic features," she said.
It is postulated
that the developing fetus falls short on oxygen and other nutrients in an environment
complicated by placental insufficiency and inflammation leading to poor neurodevelopmental
outcomes.
Dr Cheryl
Walker advises women to maintain a healthy weight and daily physical activity
to improve placental function. Maternal supplementation with low dose aspirin
and statins, have shown some promising results in recent studies in diminishing
the cellular and end organ damage due to placental insufficiency probably due
to improving perfusion.
References:
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