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association btwn morbidity, preterm birth, autism

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association btwn morbidity, preterm birth, autism

Postby caryn » Mon Oct 26, 2009 07:30 pm

by caryn (10124 Posts), Mon Oct 26, 2009 07:30 pm

Compared with infants born at term, the unadjusted ORs for autistic disorders among very and moderately preterm infants were 2.05 [95% CI: 1.26-3.34] and 1.55 [95% CI: 1.22-1.96], respectively. When we controlled for maternal, pregnancy, and birth characteristics, ORs were reduced to 1.48 [95% CI: 0.77-2.84] and 1.33 [95% CI: 0.98-1.81], respectively. When we also controlled for neonatal complications, ORs were 0.98 [95% CI: 0.45-2.16] and 1.25 [95% CI: 0.90-1.75], respectively. Reductions in risks of autistic disorders related to preterm birth were primarily attributable to preeclampsia, small-for-gestational age birth, congenital malformations, low Apgar scores at 5 minutes, and intracranial bleeding, cerebral edema, or seizures in the neonatal period. Neonatal hypoglycemia, respiratory distress, and neonatal jaundice were associated with increased risk of autistic disorders for term but not preterm infants...

http://www.ncbi.nlm.nih.gov/pubmed/19841112

So it's not being a preemie that makes autism risk higher; it's being a complicated preemie. Preeclampsia may be first on that list because it accounted for a plurality of cases. This makes sense to me, because autism's been linked to maternal auto-antibodies that target the growth of the fetal (but not newborn) brain.

Preeclampsia's probably what happens when the placenta is invasive enough that the head-through-pelvis problem becomes a significant problem. (This goes back to Haig's work on maternal-fetal conflict, and the idea that the dynamic control of the blood supply through the placenta is hotly debated between the maternal and paternal cells, since the mother wants it to not just thrive but to *fit out*, kthx.)

So if you're preeclamptic, and the baby's head is *still* too big to fit out, perhaps you start producing autoantibodies to restrict the size of the head.

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