No Association Between Mothers With Flu And Autism Spectrum Disorders

It is known that fever and maternal infections during pregnancy are associated with an elevated risk for the development of autism spectrum disorders (ASDs). There has, however, been no study to investigate whether an association exists between receiving the influenza vaccine during pregnancy and babies of these pregnant women developing autism spectrum disorders. The objective of the study, that will be discussed, was to then determine whether such risk existed.

The study

Researchers at Kaiser Permanente Northern California in Oakland, California collected and analyzed data from nearly 197,000 children born between 2000 and 2010, and who were at least 24 weeks gestational age during their mothers' pregnancies. This information included the prevalence of maternal influenza infection, as defined by clinical diagnostic codes or positive laboratory results, and influenza vaccinations given to pregnant women recorded from conception date to delivery date. 

This information was then compared to the clinical diagnoses of children with ASDs, born from the above-mentioned mothers, identified by clinical diagnostic codes on at least 2 occasions any time from their births until June 2015.

The findings

When all the data was captured and analyzed, the following findings were made:

• 1,400 mothers (0.7% of the sample size) were diagnosed with influenza and over 45,000 mothers (nearly 23%) had received the influenza vaccine during pregnancy.
• Over 3,100 children were diagnosed with ASD.
• It was determined that maternal influenza infection or influenza vaccination administered at anytime during pregnancy was not associated with an increased risk of children developing ASD. 
• Regarding trimester-specific findings, influenza vaccine given during the first trimester of pregnancy was the only period associated with an increased risk of children developing ASD. A special note was made though that this association could be due to chance and was therefore not statistically significant.

There were a few limitations to this study as well as the fact that causality of ASD, due to maternal infections and exposure to flu vaccines, couldn't be established. 

READ Flu Season Survival Guide: 10 Easy Steps to Avoid Cold and Flu

The clinical significance

Health care professionals can use this information to put mothers minds at ease when it comes to worrying about whether autism in their children has anything to do with flu vaccine exposure when they were pregnant with their children. 

Further research

The researchers have also stated that the issue of the increased risk of developing ASD due to administration of the flu vaccine in the first trimester of pregnancy, which was attributed to chance, warrants further clinical studies to investigate and evaluate whether there are any potential associations between these aspects.

Autism Spectrum Disorder

Autism spectrum disorder (ASD) is a neuro-developmental disorder that seriously impacts a child's ability to communicate and interact with others. ASD is associated with restricted and repetitive activities and behaviours that cause impairment in social and occupational functioning.

ASD includes disorders that were previously regarded as separate and they are: autism, childhood disintegrative disorder, Asperger's syndrome and pervasive developmental disorders not otherwise specified.

Causes

• Genetic problems - autism spectrum disorder can be linked with genetic conditions such as fragile-X or Rett syndrome, and in other children genetic mutations may increase the risk of autism spectrum disorder.
• Environmental factors - problems such as air pollutants, pregnancy-related complications and viral infections are being researched as possible factors leading to autism spectrum disorder.

Risk factors

The following scenarios make children more susceptible to developing ASD.

• Babies born before 26 weeks of pregnancy.
• Boys have a four times higher chance of developing ASD than girls do.
• There may also be a connection between children born to older parents and ASD, but more research is necessary to establish this link.
• Families who have one child with ASD have an elevated chance of having another child with the disorder. 
• Children with certain medical conditions such as fragile-X syndrome, Tourette syndrome, tuberous sclerosis and Rett syndrome have a higher than normal risk of developing ASD.

Symptoms

The following are some common actions and behaviours that can be experienced by children diagnosed with ASD. Each child will have a unique presentation as they may not show all these behavioural and learning problems. Therefore, the health care professional making the diagnosis will have to assess the child over a couple to a few consultations to be sure that the child had ASD.

Patterns of behaviour

• Performing repetitive motions such as spinning or rocking back-and-forth, and even dangerous behaviour such as banging their heads.
• They move around constantly.
• The slightest change in their specific rituals or routines disturbs them.
• They develop unusual movement patterns such as walking on their toes and can have issues with their coordination.
• They are resistant to change and can become uncooperative.
• They can experience an unusual sensitivity to touch, sound and light, but be oblivious to pain.
• They can become fixated with an abnormal focus or intensity on a toy or object.
• These children may not like to take part in make-believe or imitative play.

READ Flu And Fever During Pregnancy Boost Autism Risk

Social interaction and communication

• Don't respond to their names or they don't seem to hear you.
• There's a delay in speech or they may not want to talk.
• Socially withdrawn and prefer playing alone.
• They don't appear to understand simple directions or questions.
• There's lack of a facial expression and also seem to have poor eye contact.
• Talk with an abnormal rhythm or tone.
• They may only begin a conversation to make a request.
• They can be disruptive, aggressive or passive during social interaction.
• Repeating phrases or words "parrot-fashion".
• They appear unaware of others' feelings and don't show any emotions.

Management

Reducing ASD symptoms and supporting learning and development allows the child to be able to function at a higher level. Treatment options may include:

• Educational therapies - these children respond well to highly structured educational programmes. A variety of activities are included that help to improve behaviour, communication and social skill. It has been shown that pre-school children who receive comprehensive and meticulous behavioural interventions often show good progress.
• Communication and behavioural therapies - these therapies focus on teaching new skills and reducing problem behaviours. Certain other therapies will focus on teaching children on how to communicate better with others and how to act in social situations. Children with ASD don't always outgrow their symptoms, but they learn to function better socially.
• Family therapies - these therapies teach parents and other family members to learn how to interact and play with their children in ways that helps to teach them to communicate effectively, manage problem behaviours, improve daily living skills and promote social interaction skills.
• Medications -  unfortunately, there isn't any medication that can improve the core signs of ASD. There are treatments available though that help control certain symptoms such as anti-psychotic drugs for severe behavioural problems and anti-depressants for anxiety.