Reducing the Risk of Autism in Future Children: What You Need to Know

Preventing the birth of a child with autism?

If my girlfriend has two younger brothers, one with autism and the other with Asperger's syndrome, if we were to get married and have children in the future, would there be a significantly high chance of having a child with autism? How can we avoid having a child with autism? Are there any medical methods to prevent this, and what are the costs and success rates? Additionally, I have a family member who has had depression but is now cured.

jackie, 30~39 year old female. Ask Date: 2019/06/28

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the etiology of autism (Autism Spectrum Disorder) is currently uncertain.
Researchers tend to believe that there is a genetic predisposition leading to central nervous system abnormalities.
Possible factors include:
1.
Genetic Factors: In about 20% of autism patients, there is a family history of intellectual disabilities, language development delays, and similar autistic traits.
Additionally, approximately 10% of autistic boys have Fragile X syndrome.
2.
Viral Infections During Pregnancy: Women who contract viral infections such as rubella or influenza during pregnancy may experience fetal brain development impairment, which can lead to autism.
3.
Metabolic Disorders: Congenital metabolic disorders like phenylketonuria can disrupt brain cell function and impair the transmission of neural signals, potentially resulting in autism.
4.
Brain Injury: Factors such as perinatal complications, premature birth, difficult labor, neonatal brain injury, and infections like encephalitis or meningitis during infancy can increase the risk of autism due to brain damage.
Asperger's syndrome is considered a variant of autism and falls under the category of Pervasive Developmental Disorder (PDD), indicating that it may broadly affect the development of various abilities and is classified as a developmental disorder.
There is still insufficient evidence to determine the pathogenic factors of Asperger's syndrome, which may be similar to those of autism, originating from brain dysfunction.
Gillberg found that 43% of children with Asperger's syndrome experienced delivery complications, such as asphyxia, at birth.
Other reports indicate that Asperger's syndrome is often associated with conditions like Fragile X syndrome.
Children with Asperger's have also been found to exhibit structural brain changes, such as brain atrophy and ventricular enlargement.
In terms of genetics, although monozygotic twins have a higher concordance rate than dizygotic twins, Asperger's syndrome is not currently believed to be entirely hereditary.
Since the etiologies of both conditions remain unclear, there are no specific preventive measures, meaning there are no vaccines or special methods to prevent autism.
General prevention primarily focuses on preventing brain injury, such as emphasizing prenatal care, ensuring mothers are immune to rubella before pregnancy, avoiding brain injury during delivery, and mitigating factors that could cause brain injury postnatally.
These measures may help reduce the likelihood of developing autism.
Thank you! Wishing you peace and health.
Dr.
Zhang

Reply Date: 2019/06/28

More Info

When considering the potential risk of autism in future children, especially in the context of family history, it is essential to understand the multifaceted nature of autism spectrum disorders (ASD). Autism is a complex neurodevelopmental condition characterized by challenges in social interaction, communication, and repetitive behaviors. The exact causes of autism are still not fully understood, but research indicates that both genetic and environmental factors play significant roles.

Genetic Factors
Your concern about the likelihood of having a child with autism is valid, particularly given your girlfriend's family history. Studies suggest that there is a genetic component to autism. For instance, if a sibling has autism, the risk for other siblings to also be diagnosed with autism is higher than in the general population. However, it is important to note that while genetics can increase the risk, they do not guarantee that a child will be affected.
Research indicates that about 20% of children with autism have a family history of similar conditions, which can include not only autism but also other developmental disorders. The presence of conditions like Fragile X syndrome, which is associated with autism, can also be a factor. However, the inheritance pattern is complex and not fully understood, meaning that many children born to parents with a family history of autism may not develop the condition.

Environmental Factors
In addition to genetic predispositions, environmental factors during pregnancy can also influence the risk of autism. Some studies have suggested that maternal infections during pregnancy, exposure to certain medications, and complications during birth may increase the risk of autism. For instance, maternal exposure to teratogens (substances that can cause malformation) during critical periods of fetal development has been linked to a higher incidence of autism.

Preventive Measures
While there is no guaranteed method to prevent autism, there are several steps that prospective parents can take to potentially reduce the risk:
1. Preconception Health: Ensuring that both partners are in good health before conception can be beneficial. This includes managing chronic health conditions, maintaining a healthy diet, and avoiding harmful substances such as alcohol and tobacco.

2. Prenatal Care: Regular prenatal check-ups are crucial. Pregnant women should receive vaccinations, including the rubella vaccine, to prevent infections that could affect fetal development.
3. Genetic Counseling: Given your girlfriend's family history, consulting with a genetic counselor may provide valuable insights. They can assess the risk based on family history and may suggest genetic testing if appropriate.

4. Healthy Lifestyle Choices: Maintaining a healthy lifestyle during pregnancy, including proper nutrition, regular exercise, and stress management, can contribute to overall fetal health.

Costs and Success Rates
The costs associated with genetic counseling and prenatal care can vary widely depending on location and healthcare systems. Genetic counseling sessions typically range from $100 to $300, while prenatal care costs can vary based on insurance coverage and specific medical needs.
As for success rates, while there are no definitive statistics on the effectiveness of these measures in preventing autism, many healthcare professionals advocate for a proactive approach to maternal health, which can positively impact overall pregnancy outcomes.

Conclusion
In summary, while there is an increased risk of autism in children with a family history of the condition, it is not a certainty. A combination of genetic and environmental factors contributes to the development of autism, and while there is no foolproof way to prevent it, taking proactive steps in preconception and prenatal care can help mitigate some risks. Consulting with healthcare professionals and genetic counselors can provide personalized guidance tailored to your specific situation.

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