Monday October 15, 2018

Novel Blood Test May Predict Autism Risk in Babies During Pregnancy

These are exciting results as they hint at differences in some metabolic processes that potentially play a role in increasing the risk of having a child with autism

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Pregnancy, autism
New blood test in pregnancy to predict autism risk in babies. Pixabay
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Researchers have developed a novel blood test for pregnant mothers that can, with nearly 90 per cent accuracy rate, predict the probability of having a child that will be diagnosed with autism.

According to studies, if a mother has previously had a child with autism, the risk of having a second child with the developmental disorder is approximately 18.7 per cent, whereas the risk in the general population is approximately 1.7 per cent.

In the study, led by Juergen Hahn, Professor at Rensselaer Polytechnic Institute in New York, metabolites of the folate-dependent transmethylation and transsulfuration biochemical pathways of pregnant mothers were measured to determine whether or not the risk of having a child with autism could be predicted by her metabolic profile.

Pregnant mothers who have had a child with autism before were separated into two groups based on the diagnosis of their child whether the child had autism or not.

Pregnancy
Representational image. Pixabay

Then these mothers were compared to a group of control mothers who have not had a child with autism before.

The results, appearing in the journal Research in Autism Spectrum Disorders, showed that while it is not possible to determine during a pregnancy if a child will be diagnosed with autism by age 3, they did find that differences in the plasma metabolites are indicative of the relative risk (18.7 per cent vs 1.7 per cent) for having a child with autism.

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“These are exciting results as they hint at differences in some metabolic processes that potentially play a role in increasing the risk of having a child with autism,” Hahn said.

“However, it would be highly desirable if a prediction based upon physiological measurements could be made to determine which risk group a prospective mother falls into,” Hahn noted. (IANS)

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C-Section Births Doubles In Number, Reaching Epidemic Proportions: Doctors

C-section is a type of major surgery, which carries risks that require careful consideration

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C-section
A newborn, one of 12 babies born by C-section, cries inside an incubator at the Bunda Hospital in Jakarta, Indonesia, Dec. 12, 2012. Several hospitals in Indonesia's main cities performed more cesareans than usual with new mothers hoping a 12-12-12 birth date will bring luck to their newborns. VOA

Worldwide cesarean section use has nearly doubled in two decades and has reached “epidemic” proportions in some countries, doctors warned Friday, highlighting a huge gap in childbirth care between rich and poor mothers.

They said millions of women each year may be putting themselves and their babies at unnecessary risk by undergoing C-sections at rates “that have virtually nothing to do with evidence-based medicine.”

In 2015, the most recent year for which complete data is available, doctors performed 29.7 million C-sections worldwide, or 21 percent of all births. This was up from 16 million in 2000, or 12 percent of all births, according to research published in The Lancet.

It is estimated that the operation, a vital surgical procedure when complications occur during birth, is necessary 10-15 percent of the time.

c-section
The Yusuf Dantsoho Memorial Hospital has a high success rate with C-sections. Kaduna, Nigeria. Photo by Chika Oduah, VOA

Varying country rates

But the research found wildly varying country rates of C-section use, often according to economic status: In at least 15 countries, more than 40 percent births are performed using the practice, often on wealthier women in private facilities.

In Brazil, Egypt and Turkey, more than half of all births are done via C-section.

The Dominican Republic has the highest rate of any nation, with 58.1 percent of all babies delivered using the procedure.

But in close to a quarter of nations surveyed, C-section use is significantly lower than average.

c-section
Maternal death and disability rates are higher after C-section Flickr

Reasons to opt for surgery

Authors pointed out that while the procedure is generally overused in many middle- and high-income settings, women in low-income situations often lack necessary access to what can be a life-saving procedure.

“We would not expect such differences between countries, between women by socioeconomic status or between provinces/states within countries based on obstetric need,” Ties Boerma, professor of public health at the University of Manitoba, Winnipeg, and a lead author on the study, told AFP.

Jane Sandall, professor of social science and women’s health at King’s College London and a study author, told AFP that there were a variety of reasons women were increasingly opting for surgery.

These include “a lack of midwives to prevent and detect problems, loss of medical skills to confidently and competently attend a vaginal delivery, as well as medico-legal issues.”

C-section
It also identified an emerging gap between wealthy and poorer regions within the same country. Flickr

Doctors are often tempted to organize C-sections to ease the flow of patients through a maternity clinic, and medical professionals are generally less vulnerable to legal action if they choose an operation over a natural birth.

Sandall also said there were often “financial incentives for both doctor and hospital” to perform the procedure.

The study warned that in many settings young doctors were becoming “experts” in C-section while losing confidence in their abilities when it comes to natural birth.

Income a factor

It also identified an emerging gap between wealthy and poorer regions within the same country. In China, C-section rates diverged from 4 percent to 62 percent; in India the range was 7-49 percent.

C-sections
Worldwide, more than 11 percent of babies are born premature. Pixabay

While the U.S. saw more than a quarter of all births performed by C-section, some states used the procedure more than twice as often as others.

“It is clear that poor countries have low C-section use because access to services is a problem,” Sandall said. “In many of those countries, however, richer women who live in urban areas, have access to private facilities have much higher C-section use.”

Risks to mother, child

C-sections may be marketed by clinics as the “easy” way to give birth, but they are not without risks.

Maternal death and disability rates are higher after C-section than vaginal birth. The procedure scars the womb, which can lead to bleeding, ectopic pregnancies (where the embryo is stuck in the ovaries), as well as still- and premature future births.

 

c-section
Doctors are often tempted to organize C-sections to ease the flow of patients through a maternity clinic. Flickr

 

The authors suggested better education, more midwifery-led care and improved labor planning as ways of ensuring C-sections are only performed when medically necessary, as well as ensuring women properly understand the risks involved with the procedure.

“C-section is a type of major surgery, which carries risks that require careful consideration,” Sandall said.

Also Read: Novel Blood Test May Predict Autism Risk In Babies During Pregnancy

In a comment accompanying the study, Gerard Visser of the University Medical Centre in the Netherlands, called the rise in C-sections “alarming.”

“The medical profession on its own cannot reverse this trend,” he said. “Joint actions are urgently needed to stop unnecessary C-sections and enable women and families to be confident of receiving the most appropriate care for their circumstances.”