Discussing Maternal Health with Vice President Harris
Posted on by Lawrence Tabak, D.D.S., Ph.D.
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Developmental biology would suggest the first place to start is probably maternal nutrition and exposure to pathogens (recall Zika?) and chemicals. An area that is woefully lacking in the lower stratum of the socio-economic scale; and a problem that is not just limited to the functions of the NIH.
I think the great majority of pregnant women are under a doctor’s care in the US – so, if expectant mothers accurately report what they are eating, maternal nutrition is probably well documented – certainly weight gain is. It is interesting to note, and not often reported, one study of women in the Kaiser system, by Lisa Croen, IIRC, found double the rate of autism in overweight or obese mothers than in, I think it was, those considered a healthy weight. This study offended many, but if you think about it, it is extremely unlikely the study was flawed- because weight is carefully charted, and the autism diagnosis was not done by the OBGYN staff, but entirely different people a few years later.
It is also thought some autism results from Vitamin D deficiency in the mother, and supplementation before pregnancy is suspected to be ideal.
I am skeptical there is any low hanging fruit (except for mothers actually following doctor’s orders) in this field.
Hasn’t there been some correlation with “old” sperm in autism as well? The epigentics of a sperm from a 20 or 30 year old likely has different characteristics from one who is 50, 60 or 70+. Mothers are not the only part of the equation here and in some sense they are spared that insult thanks to menopause. But I guess it says more about how this society perceives child-care, where even in double income earning households, “moms” end up picking up the majority of the family issues. There is no leaning in on this–kids grow up observing parents and learn ingrained behavior that they deem is acceptable from that. All those college educated people should learn to sit down and do an Excel spreadsheet of the costs of child rearing and then assess whether they can afford it and if they can, factoring in how nanny care may be different than parental care.
Thanks to Director Dr Tabak for highlighting the important role of health in pregnancy. I emphasize the problem of intrahepatic cholestasis gestosis. In the eighth month of pregnancy, suddenly a woman began to suffer from itching:
dramatic increase in bilirubin and liver enzymes, no particular cause was found. Childbirth is induced by pharmacological means: the mother and the child are saved, blood chemistry parameters quickly return to normal.
Drugs in Pregnancy
The presence of diseases and related drugs in pregnancy is often a problem.
But in the case of ocular hypertension, sometimes the patient has the pleasant surprise of not needing the eye drops used until before pregnancy or needing fewer drugs; this is due to a temporary spontaneous normalization of ocular pressure.
However, taking some antiglaucoma eye drops remains a cause for concern, especially in the first trimester of pregnancy: the intake of which by the mother has a potential risk of harm for the child, while for the mother there is a risk of compromising ocular health if she suspends the therapy (especially if her eyes are already compromised). In these cases, I always believe that consent with gynecologists and pediatricians is necessary.
Finally, I recall the case of Thalidomide Chirality : is reported that only the (S)-enantiomer of thalidomide is teratogenic, while the (R)-enantiomer is not.