Valproate taken during pregnancy linked to autism risk.
Posted by on May 8, 2013 - 12:08pm

Women who take valproate (Depacon) during pregnancy may increase the risk of childhood autism and its spectrum disorders in their children, a population-based study showed.

In utero exposure to the drug was associated with a five-fold elevated risk of autism and three-fold elevated risk for autism spectrum disorder, Jakob Christensen, PhD, of Denmark's Aarhus University Hospital, and colleagues found.

The absolute risks were 2.5% and 4.4%, respectively, and remained significantly elevated after adjustment for parents' epilepsy and psychiatric disease, the group reported in the April 24 issue of the Journal of the American Medical Association.

"For women of childbearing potential who use anti-epileptic medications, these findings must be balanced against the treatment benefits for women who require valproate for epilepsy control," they concluded.  But "because autism spectrum disorders are serious conditions with lifelong implications for affected children and their families, even a moderate increase in risk may have major health importance," they added.

The American Academy of Neurology recommends avoiding valproate in pregnancy whenever possible due to cognitive and physical birth defect problems for children exposed in utero.

The additional risk of autism and spectrum disorders needs to be included in counseling for women now too, Kimford Meador, MD, and David Loring, PhD, both of Emory University in Atlanta, recommended in an accompanying editorial.

"Because approximately half of the pregnancies in the U.S. are unplanned, delaying discussions of treatment risks until a pregnancy is considered will leave a substantial number of children at unnecessary risk," they warned. "Women of childbearing potential should be informed of the potential risks of fetal valproate exposure before valproate is prescribed."

The drug has an indication for manic and mixed episodes in bipolar disorder and for migraine prevention in addition to seizure control.

Primary source: Journal of the American Medical Association

 

Prenatal alcohol drinking linked to childhood brain development
Posted by on November 10, 2012 - 10:53am

Heavy drinking during pregnancy disrupts proper brain development in children and adolescents years after they were exposed to alcohol in the womb, according to a study supported by the National Institutes of Health. The study is the first to track children over several years to examine how heavy exposure to alcohol in utero affects brain growth over time.

Using magnetic resonance imaging (MRI) scans, researchers found that brain growth patterns in children whose mothers drank heavily while pregnant differed from normal patterns of development seen in children who were not exposed to alcohol before birth.

The findings suggest that children with heavy alcohol exposure have decreased brain plasticity – the brain's ability to grow and remodel itself based on experience with the outside world. Such adaptation continues throughout one’s life and is crucial to learning new skills and adapting to the environment.

"This study documents the long-term impact of heavy prenatal alcohol exposure on brain development," said Ken R. Warren, Ph.D., acting director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), which provided most of the funding for the study.

"It underscores that heavy drinking during pregnancy often has lasting consequences for the child’s growth and development, and reminds us that women who are, who may be, or who are trying to become pregnant, should not drink alcohol."

The study currently appears online in the Oct. 31, 2012 issue of The Journal of Neuroscience.

During normal development, brain volume increases rapidly at a young age as new neural connections are formed, and then decreases in certain regions during adolescence as underused brain connections are cleared away to increase efficiency. While unexposed children showed this pattern of robust growth and reduction in the brain’s outmost layer, known as the cerebral cortex, those heavily exposed to alcohol typically only lost cortical volume.

In addition, heavier alcohol exposure was linked to lower intelligence, greater facial abnormalities, and little change in brain volume between scans.

The study findings may have implications for developing early treatments that could correct or improve these patterns of abnormal brain development.   The study authors write that this work may also help to understand and treat other disorders with abnormal brain growth in childhood and adolescence, such as autism.

This study was performed in conjunction with the Collaborative Initiative on Fetal Alcohol Spectrum Disorders, a consortium of FASD researchers supported by NIAAA. (More information at: www.cifasd.org)

 

 

 

Autism on the rise
Posted by on April 2, 2012 - 2:17pm

The Centers for Disease Control and Prevention (CDC) estimates that 1 in 88 children in the United States has been identified as having an autism spectrum disorder (ASD), according to a new study released today that looked at data from 14 communities.  Autism spectrum disorders are almost five times more common among boys than girls – with 1 in 54 boys identified.

The number of children identified with ASDs ranged from 1 in 210 children in Alabama to 1 in 47 children in Utah.  The largest increases were among Hispanic and black children.  The report, Prevalence of Autism Spectrum Disorders – Autism and Developmental Disabilities Monitoring Network, 14 Sites, United States, 2008, provides autism prevalence estimates from 14 areas.

“This information paints a picture of the magnitude of the condition across our country and helps us understand how communities identify children with autism,” said Health and Human Services (HHS) Secretary Kathleen Sebelius.  To address this, the National Institutes of Health has invested in research to identify possible risk factors and effective therapies for people with ASDs.

Study results from the 2008 surveillance year show 11.3 per 1,000 8-year-old children have been identified as having an ASD.  This marks a 23 percent increase since the last report in 2009.  Some of this increase is due to the way children are identified, diagnosed and served in their communities, although exactly how much is due to these factors is unknown.  “To understand more, we need to keep accelerating our research into risk factors and causes of autism spectrum disorders,” said Coleen Boyle, Ph.D., M.S.Hyg., director of CDC’s National Center on Birth Defects and Developmental Disabilities.  The study also shows more children are being diagnosed by age 3, an increase from 12 percent for children born in 1994 to 18 percent for children born in 2000. “Unfortunately, 40 percent of the children in this study aren’t getting a diagnosis until after age 4. We are working hard to change that,” said Boyle.

The most important thing for parents to do is to act quickly whenever there is a concern about a child’s development and to talk you your doctor if there is a concern.

For information on CDC’s tools to help families track their child’s development, visit HERE.

To learn more about the research CDC is doing on autism, visit www.cdc.gov/ncbddd/autism/research.html.