Many parents worry about autism. It’s difficult in part to reassure parents, because we know so little about what causes it. We know that vaccines are not a cause and we know that for some children, there is a genetic predisposition. Recent data showed that a subset of children with autism shared a series of genetic mutations unlikely to be coincidental. We also know several things that appear to be associated with an increased risk of having a child with autism including advanced paternal age, use of antidepressants during the period surrounding conception, premature birth, small-for-gestational-age at birth, family members with autism, and now it seems other intrauterine factors may have an influence.
Women who were obese, had diabetes, or high blood pressure in pregnancy were significantly more likely to have a child with autism than otherwise healthy pregnant women. These women were also more likely to have children with other developmental issues, reinforcing the idea that autism is one of several conditions that a combination of genetics and environment influence. Why women with these health conditions during pregnancy were more likely to have affected children is unclear but it seems that just as the diagnostic criteria for autism are under scrutiny and more children are identified as being on the autism spectrum, we are no closer to really nailing down the cause of this challenging condition.
We understand risk factors and sometime these risk factors can be controlled or modified by parents but understanding the mechanism by which these risk factors influence the brain to bring about the characteristic features of autism spectrum disorders remains murky. By discussing the risk factors, sometimes I worry that I will just increase anxiety without offering much in the way of helping parents really identify which things are real issues for their particular child. Frustrating…..
Understanding the confusing information can be challenging. Parents who want a reliable resource for information about autism signs, interventions, and management should check out the AAP’s Sound Advice on Autism site. It’s full of good information!