CHICAGO – Environmental factors may play a greater role in autism than previously thought, tipping the scale away from a strict focus on genetics, two studies suggest.

In one, a team at Stanford University compared cases of autism in identical and fraternal twins and found that fraternal twins — who share only half of the same genes — have unusually high rates of autism, suggesting that factors other than genetics may be triggering the disease.

In another, researchers at health insurer Kaiser Permanente found mothers of children with autism were twice as likely to have been prescribed a common antidepressant during the year before their pregnancy than mothers of healthy children.

And the risk was even greater — a threefold increase — when the drug was taken in the first trimester of pregnancy.

The findings, released in the Archives of General Psychiatry, suggest that something in the birth environment — drugs, chemicals or infections — may be triggering autism in children who are already genetically predisposed to develop the disease.

“It has been well-established that genetic factors contribute to risk for autism,” Clara Lajonchere, a study co-author and vice president of clinical programs for Autism Speaks, said in a statement.

“We now have strong evidence that, on top of genetic heritability, a shared prenatal environment may have a greater than previously realized role in the development of autism.”

Autism is a spectrum of disorders ranging from a profound inability to communicate and mental retardation to relatively mild symptoms such as with Asperger’s syndrome.

It affects one in every 150 children born today in the United States, or about 1% of the population.

SHARED ENVIRONMENT

The Stanford study involved 54 pairs of identical twins, who share 100% of the same genes, and 138 pairs of fraternal twins, who share half of the same genes.

In each pair, at least one of the twins had been diagnosed with autism.

The researchers found the chances of both children having autism spectrum disorder was higher among identical twins than among fraternal twins. But fraternal twins were much more likely to develop autism than studies of children in families where a sibling has autism.

According to the study, environmental factors common to twins explain about 55% of the cases of autism, and while genetic factors still play a role, it is much lower than seen in other studies of twins and autism.

“Environmental factors play a bigger role than previously thought,” said Dr. Joachim Hallmayer of Stanford University School of Medicine in California, who led the study.

Recent studies have suggested genetics played the biggest role in autism, but his findings suggest something different, he said in a telephone interview.

“We have to study both the genetics and the environment,” Hallmayer said. “If we look only at one side, I don’t think that will lead us to the right answer.”

COULD IT BE ANTIDEPRESSANTS?

In a separate study in the same journal, a team led by Lisa Croen, director of the Autism Research Program at the Kaiser Permanente Division of Research in Oakland, California, looked to see whether antidepressants known as selective serotonin reuptake inhibitors, or SSRIs, contributed to autism risk.

The team studied nearly 300 children with autism and 1,500 randomly selected children and then checked their mothers’ medical records.

They found mothers of the children with autism were twice as likely to have taken an antidepressant in the year before delivery than children in the control group.

And the effect was strongest — three times higher — when the drugs were taken in the first trimester of pregnancy.

“Our results suggest a possible, albeit small, risk to the unborn child associated with in utero exposure to SSRIs,” Croen said in a statement.

But she said this risk must be balanced with the risk to the mother of having untreated depression.

The team cautioned that the SSRI study was preliminary and said much more work was needed to understand the link between antidepressants and autism.

“There are real risks to not being treated for a serious illness like depression. You have to weigh the options,” said Dr. Thomas Insel, director of the National Institute of Mental Health.

“A threefold increase in risk is not insignificant. It is worth taking that into account with other factors,” Insel said in a telephone interview.

Insel, whose agency funded the twins study, said it is not yet clear what environmental factors may be triggering autism.

“It could be a range of things from infection to chemical exposures. We simply don’t know.”

What is becoming clear, he said, is that the exposure is likely occurring before childbirth.

“From all the studies that so far have concluded, that is where the evidence seems to be going,” he said.

(Editing by Doina Chiacu)

LONDON – Researchers studying autistic toddlers have discovered their brain activity appears to be out of sync at a very early stage — a finding that sheds light on the biology of the condition and may help in earlier diagnosis.

In research published in the journal Neuron, scientists in Israel used functional magnetic resonance imaging (fMRI) to look at the brains of sleeping toddlers and found that certain types of neural activity are disrupted in autistic children but not in typical children or in others with delayed language development.

“What we looked at is how the activity is synchronised,” Ilan Dinstein of Weizmann Institute of Science in Israel, who led the study, said in a telephone interview.

“And we found that the synchronisation was different — specifically in toddlers with autism and across the hemispheres (of the brain) in areas related to language and communication.”

Autism is a complex and mysterious brain disorder usually first diagnosed in early childhood. It is characterised by difficulties in social interaction, communication, and understanding other people’s emotions and behaviour.

Autism disorders are diagnosed in up to one in 100 children in the United States and Europe and affect four times as many boys as girls, but the condition is very often misdiagnosed and doctors are keen to find biological measures to help pinpoint diagnosis and make it more accurate.

“There’s a tremendous amount of misdiagnosis in many different forms,” Dinstein said. “A child that might seem autistic at one and a half years old may turn out at three years old to have language delay or some other developmental disorder. So one of the reasons to look for a biological measure is to clarify the issue of diagnosis very early on.”

The human brain is split into two separate hemispheres, which are mostly symmetrical in terms of anatomy and function.

Dinstein explained neural activity continues even during sleep and in a typical brain, normally correlates to certain patterns. Scientists believe the strength of synchronisation between functionally related areas in the right and left hemispheres may be a measure of how well the brain is working.

Dinstein’s team recorded brain activity in sleeping toddlers with typical development, language delay, and autism.

Their results showed a specific abnormality in synchronisation between two brain areas commonly associated with language and communication in 70 percent of toddlers with autism, but only in a handful of the typically developing toddlers or those with language delay.

Dinstein said that as a potential diagnostic tool, this biological measure was “a first step”.

He said another useful aspect of this measure was its ability to be taken during natural sleep, bypassing potential problems of getting a very young child to cooperate with a test.

(Editing by Jan Harvey)

People who were born prematurely are at risk of health consequences into adulthood, new research shows.

A University of Rhode Island study of premature infants — the longest-running study of its kind — shows that premature infants grow up to be less healthy, struggle more in social situations and face a greater risk of heart problems.

Nursing professor Mary C. Sullivan has been observing some 200 people who were born pre-term for 21 years, and has found high rates of learning disabilities and generally weak immune systems.

What’s more, the less a baby weighs at pre-term birth, the higher the risk.

But those born too soon aren’t completely doomed. The study also found that supportive, loving parents and a positive school environment can mitigate the negative side-effects associated with premature birth.

“These findings are important for parents, nurses in the neo-natal intensive care units, teachers and staff in the schools, disability services offices in colleges and primary care providers,” said Sullivan.

“By identifying the issues pre-term babies face in childhood, adolescence and through adulthood, we can all be better prepared to take steps to mitigate their effects.”

Sullivan said the study supports the “fetal origins hypothesis,” which links the stress experienced by pre-term infants to chronic diseases in adulthood.

That’s because pre-term birth causes a stress response, which produces high levels of the hormone cortisol.

That hormone, Sullivan said, is essential to metabolism, immune response, vascular tone and homeostasis,

LONDON – Women who do not sleep on their left side on their last night of pregnancy have double the risk of late stillbirth compared with women who do sleep on their left side, according to a study from New Zealand.

The researchers who conducted the study said women should not worry because the increased risk is still very small – the chance of the baby being stillborn rises to 3.93 per 1,000 for those who don’t sleep on their left from 1.96 per 1,000 for those who do.

A significant link was also found between sleeping regularly during the day, or sleeping longer than average at night, and late stillbirth risk, the researchers said.

Tomasina Stacey of the department of obstetrics and gynaecology at the University of Auckland, whose study was published in the British Medical Journal (BMJ), suggested that restricted blood flow to the baby when the mother lies on her back or right side for long periods may explain the link.

But she said the findings, which were based on a relatively small number of women, needed to be confirmed by larger, more detailed studies before any public health advice could be given.

“It’s a new hypothesis and means we should start to look at this problem much more closely. It’s really a starting point for future research,” Stacey said in a telephone interview.

If the findings were confirmed, they might offer a simple, cheap and natural way to cut the number of stillbirths, she said. “It’s something that’s very easily modifiable. You don’t need to take any drugs and there are no side effects.”

A series of studies led by researchers from the World Health Organization and published earlier this year found that more than 2.6 million pregnancies a year end in stillbirth, many of them among women in poor countries. This means that every day more than 7,200 babies are stillborn.

Stacey’s team interviewed 155 women in Auckland who gave birth to a stillborn baby between July 2006 and June 2009 when they were at least 28 weeks pregnant. These women were compared to a control group of 310 women with ongoing pregnancies.

The women were asked detailed questions about their sleep positions, and about going to sleep and waking up before pregnancy and in the last month, week, and night before they believed their baby had died.

They were also asked about snoring, daytime sleepiness, whether they regularly slept during the day in the last month of pregnancy, the duration of their sleep at night, and how many times they got up to the toilet at night.

The results showed no link between snoring or daytime sleepiness and risk of late stillbirth. But a significant link was found between daytime sleeping, or sleeping longer than average at night, and late stillbirth risk.

Women who slept on their back or on their right side on the last night of pregnancy were also more likely to experience a late stillbirth, and women who got up to go to the toilet once or less on the last night were also more likely to experience a late stillbirth compared with women who got up more frequently.

In a commentary on the study in the BMJ, Lucy Chappell, lecturer in maternal and foetal medicine from King’s College London, said “any simple intervention that reduces the risk of stillbirth would be extremely welcome”.

But she said the results should be interpreted with caution until more work is done: “A forceful campaign urging pregnant women to sleep on their left side is not yet warranted.”

A British woman is donating her uterus to her daughter, who was born without one, so her child can have a baby of her own.

Eva Ottosson, 56, and her daughter, Sara, will undergo the transplant in Gothenburg, Sweden, the British newspaper the Telegraph reported in an interview with the mother.

It will mean, if the transplant is successful, when Sara gets pregnant, her baby will develop in the same womb she herself was born.

“My daughter and I are both very rational people and we both think ‘It’s just a womb,’” Ottosson told the newspaper.

“She needs the womb and if I’m the best donor for her … well, go on. She needs it more than me. I’ve had two daughters, so it’s served me well.”

Sara has ovaries, so doctors will remove her eggs and she’ll undergo in vitro fertilization, using her boyfriend’s sperm to fertilize the eggs in a lab setting before they are implanted into her uterus.

In 2000, doctors performed a uterus transplant on a woman, but there were problems and it had to be removed. The Swedish doctors said knowledge surrounding the procedure has improved and they have high hopes the transplant will be successful.

The transplant may raise a few eyebrows because it’s a mother giving a daughter her uterus, but Sara, who is a biology teacher, told the Telegraph she doesn’t think that way.

“It’s just an organ like any other organ,” she said.

I’ve been seeing a lot of cases of “hand, foot and mouth disease” (HFM) in the office lately. This illness is usually caused by a Coxsackie virus A-16, a member of the enteroviral family. These viruses are typically seen in the summer and early fall. (Don’t worry, this illness is not related to “hoof and mouth” disease seen in animals.)

Hand, foot and mouth disease is most common in younger children and often is seen in the toddler crowd. You can see “hand, foot and mouth” in older children, but most kids contract it at younger ages and are immune as they get older. It’s not unusual to have outbreaks of HFM in child-care centers and pre-schools.

How is Coxsachie virus transmitted? Person-to person contact, as well as from contact with contaminated surfaces. The incubation period from time of exposure is three to seven days.

Typically, a child with HFM will present with fever, which is often fairly high. If seen early in the illness, they may not have any other physical findings but over several days will develop a sore throat with painful sores on the tongue and throat.

Several days later, patients may develop the classic small, red, blister-like lesions on their palms, the soles of their feet and often in the diaper area. When they have all of the symptoms it’s an easy diagnosis, but not everyone who gets Coxsackie virus will have every symptom.

Sometimes you see a child with the classic rash on palms and soles, but they’ve never had fever or even felt badly. One of the most common complaints may be drooling and irritability in a child with fever, as the mouth and throat are sore, even before the classic lesions appear.

Because this is yet another viral infection, there’s no specific treatment and antibiotics won’t help. Keeping your child comfortable with Tylenol or Motrin/Advil will help with both fever and pain. This is a good time to try things that would help soothe a sore throat, such as ice cream, Popsicles, pudding, Jell-O, even Slurpees, especially for children refusing fluids. The main concern is keeping your child hydrated during the illness.

Once a child is fever free for 24 hours and feeling better, he or she may return to child-care or school. The small lesions on the palms and soles will clear over the next five to seven days. The best way to prevent others from getting sick is with good old hand washing.

Dr. Sue Hubbard is a well-known pediatrician and co-host of “The Kid’s Doctor” radio show. Submit questions at www.kidsdr.com.

(c) 2011, KIDSDR.COM DISTRIBUTED BY TRIBUNE MEDIA SERVICES, INC.

The risk a woman runs of developing diabetes during pregnancy can be identified as early as seven years before she gets pregnant based on measurements of blood sugar and body weight, a new study says.

The study, published in the online issue of the American Journal of Obstetrics and Gynecology, looked at data from 580 ethnically diverse women who participated in a multi-phased health checkup in northern California between 1984 and 1996.

Researchers examined data from women who had a subsequent pregnancy and compared those who developed gestational diabetes mellitus (GDM) during pregnancy to those who didn’t develop the condition. GDM is a glucose intolerance that typically occurs in the second or third trimester, and causes complications in as many as 7% of pregnancies in the U.S.

The risk of developing GDM increased with the number of risk factors associated with diabetes and heart disease present before pregnancy. Those risk factors are high blood sugar, hypertension and being overweight.

High blood sugar levels and body weight were associated with a 4.6-fold increased risk of developing GDM compared to women with normal blood sugar levels and body weight, the study found.

“Our study indicates that a woman’s cardio-metabolic risk profile for factors routinely assessed at medical visits such as blood sugar, high blood pressure, cholesterol and body weight can help clinicians identify high-risk women to target for primary prevention or early management of GDM,” said researcher Monique Hedderson.

Previous research has shown that women who develop GDM are more likely to develop Type 2 diabetes after pregnancy.

The established risk factors for developing GDM — older maternal age, obesity, a non-white race or ethnicity, giving birth to a very large baby previously and a family history of diabetes — are absent in up to half of women who develop the condition.

New research shows that children who were breastfed for more than four months as babies are less likely to be anxious, restless and antisocial by the time they turn five.

“Our results provide even more evidence for the benefits of breastfeeding,’ said Maria Quigley of Oxford University, co-author of the study, in a university press release.

“Mothers who want to breastfeed should be given all the support they need. Many women struggle to breastfeed for as long as they might otherwise like, and many don’t receive the support that might make a difference.”

Breastfeeding is already associated with higher IQs, lower levels of infection and lower rates of obesity.

The study, published in the Archives of Disease in Childhood, looked at 9,500 mothers and babies, all of whom were born full-term within a 12-month period to families with a white ethnic background.

Those moms filled out a questionnaire when their babies were nine months old detailing whether they breastfed and for how long.

When the kids were five years old, the researchers sent the mothers a second questionnaire to determine possible behaviour problems, such as anxiety, restlessness or an inability to socialize with other kids.

While 16.1% of the formula-fed babies had behavioural problems, only 6.5% of breastfed babies showed the same.

But the study’s authors warn other factors might be in play. For instance, moms who breastfeed tend to be older, richer and better educated — all factors that could contribute to their children’s behaviour.

Still, adjusting for age, education and socio-economic background, the researchers found breastfed babies were 30% less likely to have behaviour problems.

“We just don’t know whether it is because of the constituents in breast milk which are lacking in formula, or the close interaction with the mom during breastfeeding, or whether it is a knock-on effect of the reduced illness in breastfed babies,” said Quigly.

“But it does begin to look like we can add fewer behavioural problems as another potential benefit of breastfeeding.”

SAULT STE MARIE, Ont. – New mothers can lessen their chances of suffering from postpartum depression by getting in touch with their newborns, a local health consultant says.

Hilltrud Dawson encourages women to hold their babies, wearing only a diaper, against their bare chests for “quite a few hours” daily for several weeks following birth.

“We know it really has a beneficial effects on the baby,” said Dawson. “We just are now finding out all the beneficial effects it has on the mother.”

Figures show that as many as 20% of women can have postpartum mood disorders after giving birth, stillbirth or a miscarriage.

Dawson, a nurse, lactation consultant and former midwife was one of several keynote speakers at the recent Kids’ First Conference organized by Best for Kids Committee and the Algoma branch of Association for Early Childhood Educators of Ontario.

Conditions such as postpartum mood disorder and psychosis are relatively new, having only been started to be discussed in the health care community in the last 10 to 15 years.

Medication and counselling are two ways women can be helped, but Dawson acknowledged mothers in the North have more difficulty accessing help.

“The options certainly are there, but we just have to work a little bit at getting those services in all areas of Ontario, especially in Northern Ontario,” she said. “That’s still a bit of a challenge.”

NEW YORK — With her ever-demanding five-month-old son in tow, Hollywood hottie Ali Larter never knows from day to day when she’ll get time to work out.

So the 35-year-old former star of the Sci-Fi TV drama Heroes is always prepared to break into a sweat at a moment’s notice.

“From the morning through night, I just wear my workout clothes so that if I can grab a half an hour here or there “¦ then I’m ready to go,” she says in a one-on-one interview at Reebok’s recent launch of its RealFlex footwear, a first-of-its kind “barefoot” running shoe.

“Being a new mom, my time is of the essence.”

But don’t picture Larter in frumpy sweatpants and an oversized T-shirt.

On this day, the five-foot-seven New Jersey native wore a sporty ruby red top with black leggings — showing no signs of having given birth in December. Her athletic ensemble, of course, was punctuated with her pink and white Reebok RealFlex shoes.

Larter, who has been known to jog up to four times a week in LA’s Runyon Canyon Park, has become a firm believer in barefoot or natural running.

“I think this is the future,” she says, noting it’s more than a passing trend.

“What I love about the new Reebok RealFlex sneaker is that it looks good, so you’re actually dressed for the day out. But then it also helps to be anatomically correct. And I’m about alignment now. “¦ It’s about putting your weight forward so you hit the muscle groups, rather than the shock of it going to your knees.”

Her infant son, Theodore Hayes MacArthur, often goes along for the ride.

“For a lot of new moms, they don’t have someone to watch the baby, so you put him in a stroller and you just go,” she explains.

“You can walk for an hour or two hours. It gives the baby a nap. The fresh air is so important. Get yourself outside, get yourself in nature whenever you can.”

When she’s not out for a stroll or jog, the former model fits in Pilates and yoga whenever she can.

Larter — whose big-screen credits include Legally Blonde, Jay and Silent Bob Strike Back, and Resident Evil: Afterlife — aims to exercise four days a week for an hour each day.

And while her diet contains plenty of organic fare, she allows herself the occasional portion-controlled splurge.

“I’m a pretty healthy person, (but) I believe in spoiling yourself. A lot of it is to forgive yourself,” adds the actress, who is perhaps best known for the steamy scene in Varsity Blues in which she wore nothing but strategically placed blobs of what appeared to be whipped cream (it was actually shaving cream).

“New moms can be so hard on themselves and you think your body’s going to be back and perfect and you just have to realize the No. 1 priority is to have a beautiful, healthy baby.”

Her second priority is her exercise regimen.

“The biggest thing is you just have to get yourself to do it. I don’t think you’ve ever said after a workout, ‘Geez, wish I hadn’t done that.’ It really makes you feel good, so you have to flick your brain and say, ‘This is the time for me. I’m going to take this time to relieve some of the pressures of my day, work out some of the stress, the aggression.’ Let it go and really take that time for yourself.”

Cary Castagna is a certified personal trainer through Can-Fit-Pro.

Visit the Keeping Fit blog at blogs.canoe.ca/keepingfit.