Maternal illness and autism

The Pediatric Insider

© 2012 Roy Benaroch, MD

This week’s autism headline: Flu, fever during pregnancy linked to autism risk.

Researchers in Denmark reviewed health information from a group of about 100,000 children born between 1997 and 2003. The mothers had been interviewed during and shortly after their pregnancies to determine who had had infections, fevers, or other health issues during pregnancy. Now that the children had grown to 8-14 years of age, the study looked backwards to see if the children developed autism had mothers who reported more infections or fevers during pregnancy.

The good news: for many minor infections, including common colds or short-lived fevers, there was no significant association with autism. However, mothers who had recalled having the flu had about double the risk of autism in their children, and mothers who reported a fever lasting over a week had triple the risk.

The authors themselves stress that these are preliminary findings, and that their complicated mathematics could have exaggerated trends that aren’t really significant. Still, there is animal data that shows inflammation from infection during pregnancy can indeed influence fetal brain development. These findings about flu and fever are plausible.

This study adds to the growing evidence that at least in many cases, the causes of autism begin well before a baby is born. Previous research has shown in increased risk of autism with older fathers, maternal obesity, and closely spaced pregnancies. It is very likely that there are numerous, overlapping causes of autism that include genetic, prenatal, and environmental factors. We’re learning more and more, but we’ve still got far to go.

Back to the current study: the overall risk of having a child with autism following influenza is still low—there is no need for panic or extensive watchfulness. However, this study provides yet more evidence that pregnant (or expecting-to-get-pregnant) moms need to protect themselves from infection. Eat right, sleep right, wash your hands, avoid sick people. And please, get yourself and your children influenza vaccines. Want to avoid autism? Vaccinate!

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4 Comments on “Maternal illness and autism”

  1. oldmdgirl Says:

    I’ve been wondering for a while whether, if we have a second kid, the pregnancy would be more complicated just because the first is in daycare and brings home germs to the rest of the family, making us all sick. Constantly. Looks like that fear is grounded in some reality.


  2. Sunshine Says:

    Ew, sloppy writing. Jeez. Yes, people. You can avoid autism just by getting all your vaccines. And you can avoid a dead baby just by putting said baby on his back! There. Wasn’t that easy? (At least with the latter example, we have scientific evidence to suggest that minimizing the risk factor is actually effective in minimizing SIDS)


  3. Dr. Roy Says:

    Sunshine’s post reminds me to highlight another way that vaccines can prevent autism– the MMR vaccine specifically, by preventing congenital rubella syndrome, prevents some cases of autism that are caused by this infection:

    The study reviewed in the OP shows that some cases of autism seem related to maternal fevers and influenza. If this finding is confirmed, influenza prevention (including vaccination) would be a good strategy to decrease overall autism cases.

    Of course, not all (or even most) cases of autism can be prevented by vaccines. I didn’t say or imply that. But if you wish to reduce your child’s risk of autism, vaccinating can help.

    RE SIDS: the back-to-sleep campaign in the USA led to an approximately 50% decline in SIDS rates here; a similar reduction has been seen in every country that has pursued this strategy. As with vaccines, the back-to-sleep campaign has been a public health triumph.


  4. Zan Says:

    Both my mom and I have worked with children who have Autism for several years and have noticed a correlation between mothers with significant mental illness such as severe depression, bipolar, schizophrenia and children who have Autism as well as increased parental age and Autism. Are there studies about this that you know of?


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