Scientists recommend a variety of preventative measures for autism. For
the past few decades, autism has been one of the scariest mysteries of
parenting, with debate swirling around its definition, how rapidly the
epidemic is growing, and most urgently, what causes it.
That's why we
were surprised to read
a claim this weekend by science writer Moises Velasquez-Manoff in the opinion section of
The New York Times that scientists have figured it out: In at least a third of cases, autism is an auto-immune disorder that starts in the womb.
"The mother's attempt to repel invaders - her inflammatory response -
seems at fault," the story says. A range of maternal issues from
disorders like celiac disease, asthma and arthritis to getting sick
during pregnancy in the most common ways--flu, urinary tract
infections--have been shown to be significant risk factors for autism.
The story is a science-writer's synthesis (informed by a wide and
reputable body of science) but has far-reaching implications for all
pregnant women. Most surprisingly, it includes a twist on the
autism-and-vaccines story, which is that the mother being vaccinated,
even for common things like the flu, could be a risk factor for autism.
Current CDC guidelines and most obstetricians recommend routine vaccination during pregnancy.
Yahoo! Shine talked to a variety of experts and scientists whose research was quoted in the
Times
story, and found that the takeaways for pregnant women seem to be
twofold. The first is that women with conditions like celiac disease,
asthma, arthritis, metabolic syndrome or other auto-immune disorders
should be aware that they are at a higher risk for having an autistic
child.
The second is that all women may want to take sickness and infection during pregnancy more seriously, as a safety precaution.
"Everyone gets sick when they're pregnant and they don't all have
autistic outcomes," Dr. Judy Van De Water told Yahoo! Shine. Dr. Van De
Water is an immunologist who studies the immunobiology of autism in
children at the
MIND Institute at University of California, Davis.
However, she says, "If you are exposed to something [while you are
pregnant] and you respond very strongly to it, that could change factors
that come from the immune system that affect neuro-development."
"Not every vaccination or flu episode is going to result in an autistic
outcome," says Dr. Paul Patterson, a professor of biological science at
CalTech whose research was also quoted in the
Times
story. "The factors involved are probably the genetics of the woman or
the genetics of the fetus. Another factor would be the severity of the
infection or the severity of the mother's response. The timing of the
infection (first, second or third trimester). Not every infection
results in an autistic outcome! One doesn't have to be scared to death,
but it is a risk factor."
Dr Patterson's book
Infectious Behavior: Brain-Immune Connections in Autism, Schizophrenia and Depression and his
blog
go into more detail about his thinking on autism, inflammation and what
women can do. He told Yahoo! Shine that his research has shown in
animals that "activating the mother's immune system artificially has the
same effect on the offspring as the actual flu infection," a finding
which implies questions about the safety of vaccination during
pregnancy. "Getting a flu shot is controversial." Dr. Van De Water
confirms.
Dr Van De Water recommends that women get their flu shot before they
become pregnant. Dr Patterson suggests that women who decide not to get a
flu shot while pregnant take "common-sense preventative measures that
everyone already knows about but we don't do." These include: "Washing
your hands constantly, especially when you have been out in public like
going to the grocery store or putting gas in the car. Using
anti-bacterial wipes on your hands. Avoiding people who are sick, like
friends and relatives. Not eating raw meat, or don't change the cat
litter."
As of yet, doctors do not have a universal screening method to predict
which women are at risk to have autistic outcomes if they get sick
during pregnancy. However, about 15 percent of mothers with autistic
children have
auto-antibodies
in their blood. Auto-antibodies guarantee that the child will be an
autistic, Dr Van De Water says, "100 percent of the time." An
auto-antibody test for widespread usage is under development.
Though pregnant women want to take every precaution not to get sick,
ironically, Moises Velasquez-Manoff's argument locates the source of the
modern increase in auto-immune disorders to people not getting sick
often
enough. It's what's known as "the hygiene theory," which
posits that the human immune system evolved to cope with the filthy and
disease-ridden conditions of a previous era. Without microbes and
parasites as a foil, it is more likely to function improperly, causing
all kinds of health consequences including autism.