One in every 10 children is at risk
Swedish scientists from Lund University recommendIt is stated that premature birth may be one of the main reasons for the development of ASD in children.
They conducted a study of more than 4 million babies born in Sweden between 1973 and 2013 who survived to age 1. All of them were under observation due to a diagnosis of autism until 2015.
The results show that the prevalence of ASD is around 6% in babies born at 22-27 weeks (extremely preterm), 1.9-2.1% in extremely and moderately preterm babies (28-37 weeks), and 1% in babies born at 28-37 weeks. It showed that it was 4-1.6. Birth 37-41. took place in weeks.
According to the World Health Organization, approximately 15 million babies are born prematurely (before the 37th week of pregnancy) every year, and this number is increasing. This is one in ten children in the world who are at high risk of developing autism. According to Rosstat, 6 percent of those who gave birth in Russia in 2021 experienced premature birth.
There are many reasons for premature birth. These are infections, an increase in the volume of amniotic fluid and multiple pregnancies, reproductive specialist, obstetrician-gynecologist and head of the ART department of the Lifeline Reproductive and Family Planning Center told socialbites.ca.
“One of the most common causes of premature birth in the second half of pregnancy is premature effacement and dilation of the cervix. A high number of births also increases the risk of premature birth. If the body mass index of a woman planning a pregnancy exceeds 30, this always increases the risk of complications during pregnancy, such as edema, preemplasia (a serious pregnancy complication characterized by high blood pressure, protein in the urine and edema). ), eclampsia (a disease in which convulsive activity is observed and blood pressure reaches a level high enough to threaten the life of the mother and child) and high blood pressure. All these factors can also cause premature birth,” explained Ilyina.
Yulia Zinovieva, a geneticist at Life and a member of the Society of Medical Genetics and the Russian Society of Human Reproduction, noted that prematurity may indeed become an important risk factor for the development of delays in motor and psycho-speech development along with the features of ASD. Line Reproductive and Family Planning Center.
“It is clear that extremely premature children belong to the group with the highest risk of developing various pathologies. Such premature birth in a large percentage of cases is associated with intrauterine growth restriction, risk of hypoxia and intrauterine death. These symptoms are often caused by various pathologies in the fetus. Zinovieva noted that a child can be born alive and have pathologies of varying severity, including autism.
According to him, children born prematurely do not have time to develop their brain structures and other organ systems that supply oxygen to the brain, and at the same time there are atrophic changes in the cortex and basal ganglia of the brain that can contribute to development. delays. Nowadays, doctors can care for children born in extremely short term terms, so the number of children with ASD is higher.
more than 400 reasons
Psychiatrist, Doctor of Medical Sciences, Research Institute of Pediatrics and Child Health, Russian Scientific Surgical Center named after him. Akkadian BV Petrovsky Natalia Ustinova noted that this is not the only study confirming that a child born prematurely has an increased risk of developing disorders of neuropsychological development, including autism, or autism spectrum disorder (ASD), as it is now commonly called.
“It is important to emphasize that premature birth is perhaps not the beginning, but one of the stages of the process in which ASD is formed. Research also identifies common risk factors for prematurity and autism: metabolic disorders, diabetes, malnutrition, and high maternal body mass index. But the link between prematurity and autism does not necessarily mean that one causes the other. Ustinova noted that researchers are interested in possible genetic and environmental factors that affect both preterm birth and autism.
According to him, it is unlikely that it will be possible to find a single cause of autism; It is a multifactorial disease in which a combination of conditions play a role in its development, possibly some of which can lead to death at an early age. birth. Research suggests that there may be many “autisms” with similar behavioral characteristics but different etiopathogenetic mechanisms.
However, Ustinova believes that, despite numerous scientific studies, in most cases it is not possible to fully explain the causes and events that lead to autism.
“It seemed clear that something was happening to the brain. However, in most cases, people with ASD do not have changes in the brain that are not found in people without autism. For example, the bidirectional brain-gut axis is currently being actively studied. It is known that microbiota can affect brain functions and the course of neurodevelopment.
Perhaps if we manage to find the “key” to autism, this will significantly change views on the treatment of many diseases. Today it is clear that a holistic and personalized approach to medical support for children and adults with autism is needed.
Professor Tatyana Batasheva, director of the Center for Scientific and Practical Child Psychoneurology of the Moscow Ministry of Health, admits that scientists have named more than 400 different causes of ASD. These include the stress experienced by the mother during pregnancy, intrauterine infections, taking certain medications and genetic factors.
“We provide assistance to young patients with ASD in our Center for Scientific and Applied Child Psychoneurology. These include premature babies and babies born on time or slightly later. And we cannot say with certainty that prematurity is the single most important factor in the emergence of ASD. According to our experience and the experience of other colleagues, in 40% of cases, various neurological pathologies and brain diseases manifest themselves as ASD. And it is impossible to recognize this without special studies of each patient. Therefore, if there is any abnormality, it is extremely important to first be examined by a specialist neurologist,” explained Batasheva.
According to him, the prognosis of each premature baby is extremely individual and it is impossible to say that each one has ASD. Two children born at the same stage with approximately the same problems in their mothers during pregnancy have fundamentally different outcomes: from full physical and mental health to profound mental or motor disability.
“But certainly a lot always depends on correct and timely rehabilitation. Thanks to it, you can achieve very good results,” concluded the expert.
Ustinova also added that the development of ASD in a child can be prevented in the early stages of fetal development. Fetal programming can help parents with this.
“This is the theory that environmental cues during fetal development play a fundamental role in determining lifelong health trajectories. This approach identifies controllable factors that may increase the likelihood of having a healthy child. This is a basic healthy lifestyle by avoiding certain medications that trigger ASD,” he said. completed the expert.
In addition, it is extremely important to carry out prevention of premature birth, which includes competent medical supervision before birth, as well as preparation for pregnancy – timely visits to the gynecologist (at least once a year) with the preventive taking of all smears. timely treatment of all possible infections.