Health
Studies show that if a pregnant mother has an autoimmune disease, her child’s risk of ADHD may increase
Common autoimmune diseases include type 1 diabetes, ulcerative colitis, Crohn’s disease and celiac disease, psoriasis, multiple sclerosis, and rheumatoid arthritis.
“Autoimmune diseases are disorders in which the immune system accidentally” attacks “the body,” said Timothy Nielsen, research director and PhD student at the Children’s Hospital at the University of Sydney’s Westmead Clinical School. I am. This study was published in JAMA Pediatrics on Tuesday.
The attack could cause “multi-organ” disorders such as wolves, or “organ-specific” disorders such as autoimmune thyroid disease (Hashimoto’s thyroiditis or Graves’ disease), Nielsen said in an email. Stated.
According to Nielsen, neurodevelopmental disorders such as ADHD, learning disabilities, and autism are caused by disruption of fetal brain development during pregnancy. In a previous study, he said that maternal autoimmune disease was associated with autism, obsessive-compulsive disorder, and childhood tic or Tourette’s syndrome, which was the first to examine their role in ADHD. It is one of the studies.
“We hope these findings do not overstress women with autoimmune diseases,” said Dr. Jenny Radeski, a developmental pediatrician who was an assistant pediatrician at the CS Mott Children’s Hospital in Michigan Medicine who was not involved in the study. Said.
“I treat many children with ADHD, and these findings do not change the way I manage them,” said Radeski. “There may be a handful of kids with ADHD, but I love their little, vast and curious minds and their unique perspective on things.
“Although mothers with autoimmune diseases can work to optimally manage their pregnancy status, autoimmune diseases, unlike smoking during pregnancy, are another risk factor for ADHD, and mothers are more likely to do so. You can manage it directly, “she added.
Large longitudinal study
The study tracked more than 63,000 children born to maturity between 1 July 2000 and 31 December 2010 in New South Wales, Australia. Nielsen and his team have identified 12,610 mothers with at least one of 35 common autoimmune diseases. Each pregnant mother had a diagnostic code for an autoimmune disease in the linked hospitalization record.
A child was determined to have ADHD if there was a hospital diagnosis of ADHD, or a prescription or record of stimulant prescriptions.
All 12,610 offspring diagnosed with ADHD over the age of 3 were included in the study and subsequently collated with four children of the same age as the mother without autoimmune disease. We then tracked both children until the end of 2014.
The study also conducted a meta-analysis of existing studies on this topic.
Taken together, the results show that the diagnosis of autoimmune disease, type 1 diabetes, rheumatic fever or rheumatic carditis (inflammation of the heart muscle), psoriasis, and hyperthyroidism is associated with an increased risk of ADHD in later children. Indicates that you are doing.
Autoimmune disease and inflammation
It is not known exactly how the mother’s autoimmune disease affects the foetation. Researchers hypothesize that the mother’s autoantibodies (those that attack the mother’s body) cross through the placenta. Inflammatory molecules can do the same.
Once there, chronic inflammation can alter the development of the fetal brain, perhaps by affecting the innate immune cells of the developing baby’s brain, the study said. Alternatively, inflammation can alter epigenetic markers (chemicals that turn genes on or off) in the fetal major neurodevelopmental genes.
Another theory is that inflammation affects the formation and function of synapses in the baby’s developing brain. Synapses are small pockets of space between two cells that allow cells to pass messages and communicate.
“These changes can lead directly to the symptoms of ADHD, or make children more vulnerable to environmental risk factors,” Nielsen said.
In previous studies, women with autoimmune diseases who were poorly controlled by drug therapy and other treatments may be risk factors for poor pregnancy outcomes such as poor growth and preterm birth, according to Nielsen. I know there is.
“Our team is currently working on the underlying causative mechanism of the link between autoimmune disease and ADHD,” he said, “disease severity, symptoms, drug use, or other inflammation. It may reveal whether sexual factors change this risk. ADHD. “
Knowledge is power
Nielsen emphasized that pregnant women with autoimmune diseases are only one of many risk factors for childhood neurodevelopmental disorders. “But understanding the risks and manifestations of the disease is essential to prevent and treat it.”
Having knowledge of such associations empowers both women and their healthcare providers to “emphasize the importance of quality interdisciplinary care to manage autoimmune status before and during pregnancy.” Nielsen said it could be given.
“This includes good pre-pregnancy care and avoidance of pregnancy if the activity of the disease is not well controlled,” he said.
Beyond that, experts emphasize that if a child develops a disability based on the parent’s medical condition, it is not the fault of anyone.
“Sometimes parents will stick to the guilt that their child’s ADHD is their” mistake. ” “Developmental pediatrician Radeski said.
“When this happens, I will refocus their spiritual energy on understanding the unique combination of children’s strengths and challenges, why they behave like them, and how to advocate support. “She said.
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