Kate Middleton might love being pregnant, but for the average woman it can be confusing and scary. Every day we learn about some new thing that, if you do it when you’re pregnant, can totally screw up your kid. By this point, pretty much everyone knows that you shouldn’t smoke or drink during pregnancy. Even sushi can be dangerous. But then you get a lot of contradictory information: drinking a little bit is OK…or is it?
So, in case you’re pregnant or thinking about becoming pregnant, here’s some more news to totally freak you out. You can even affect your child’s chances of developing autism or obesity while you’re pregnant.
Folic acid and autism
Okay, so it might not be that big of a surprise that taking folic acid when you’re pregnant is important. Folate, one of the B vitamins, is essential for your baby’s development. Lack of folate during pregnancy can lead to devastating diseases like spina bifida. But new research from scientists in Norway suggests that not taking folic acid supplements can also increase your child’s risk of developing Autism Spectrum Disorder (ASD). This work was part of a larger research effort between the Norwegian Institute of Public Health and Columbia University in New York called the Autism Birth Cohort.
The study looked at 85,176 Norwegian babies born from 2002-2008. They looked at the foic acid consumption of mothers starting from 4 weeks before becoming pregnant to 8 weeks after pregnancy. By March 31, 2012, 270 of the children had been diagnosed with some form of autism. Among children whose mothers took folic acid supplements, 0.10% had ASD. If the mother didn’t take supplements, 0.21% were diagnosed with ASD. So, still not a huge number, but enough to make you reconsider skipping that folic acid pill.
However, there is one huge caveat: this study in no way proves that folic acid has anything to do with development of autism. Yes, the statistics are sound, the sample size is very good, and the effect was significant. But there are plenty of other factors that could be involved. Women who took folic acid also tended to be more highly educated, which like affected how well they adhered to their doctor’s other dietary recommendations. The scientists did try to control for this by also looking at fish oil supplement behaviors. Women who took fish oil also fell into the same socio-economic classes as women who took folic acid. Still, they found no correlation between fish oil use and autism diagnosis.
Either way, given the other known benefits of folic acid during pregnancy, you definitely should take it if you’re pregnant. But it’s good to know that you could also be fighting autism at the same time.
Pregnancy and obesity
Where to even begin. In recent months, we’ve seen a barrage of headlines telling us how our diets, weight, and lifestyle choices were going to make our kids get fat–and that their fate may be sealed in utero. In addition to potential complications–like gestational diabetes and labor problems–being obese during pregnancy can seriously impact your child’s life.
Just in the past two months, tons of research articles have been published about the link between a mother’s BMI and her child’s risk of obesity and other problems. One paper showed a link between a mother’s body fat and her child’s risk of developing asthma and/or “wheeze” between 6 months and 6 years of age (see Pike paper below). This may be because of the role that inflammation plays in obesity. The factors that cause inflammation may be harmful to a developing baby’s lungs. This study looked directly at the mother’s fat content. Many other studies have found links between mom’s BMI and asthma.
Another article showed that, in mice, maternal obesity can affect the development of the baby’s pancreas (see Bringhenti paper below). The pancreas is the organ that makes, among other things, insulin to control blood sugar levels. In this study, mother mice that were fed a high fat diet before, during, and after pregnancy had fatter sons with high blood sugar (only boys were looked at because…well, that’s how it’s usually done). The differences weren’t apparent right at birth. But by 10 days of age, boys from the high-fat moms were significantly fatter than boys from low-fat moms. These fatty sons also stayed fatter than sons from normal moms, for at least 3 months, and continued to have much higher blood sugar during that time, too.
At birth, sons from the fat-fed mothers also had fewer of the cells that produce insulin. That sounds really, really bad…but, those boys were able to recover by 10 days after birth and ended up having the same number of insulin-producing cells as boys from normal-diet moms. That said, there were still noticeable differences between the pancreases of sons from both groups. In particular, the proportion of the pancreas devoted to pumping out hormones, like insulin, was larger in the high-fat group, possibly because they were trying to compensate for the higher levels of sugar in the blood. That is really bad news, because if the mice are pumping out more insulin, but still have high blood sugar, it means they may be becoming insulin resistant–the main factor that leads to Type 2 Diabetes.
But that’s mice. More research is needed to see whether similar effects happen in humans. But the numerous links found between a mother’s pregnancy weight and her child’s weight does not bode well.
The problem is that no one knows why obesity during pregnancy leads to these problems. The mouse study suggests that diet itself is a large factor. But there are other factors that could be just as important: exercise, total body weight, diabetes, or other health factors. The issue with nailing down the cause-effect relationship is that each study is conducted differently, with different factors being measured. A recent article in Nutrition and Metabolism addressed the problem of unifying all of these different studies and giving useful advice to expectant mothers.
All right, so in conclusion: don’t drink (much), smoke, eat sushi, be fat, get fat, or forget your folic acid while you’re pregnant. In addition, I’m sure there are about a million other things you’re supposed to do or not do while pregnant (more examples here and here and here). And, of course, keep your eye on new research, because just like the good egg/bad egg media of the past, things are always subject to change. So, you know. Don’t freak out or anything.
Which reminds me: if you’re not pregnant, please leave pregnant women alone. They have doctors giving them advice and regular check-ups. They don’t need unsolicited advice and scolding from random strangers. Because dealing with all the health and pregnancy warnings from the professionals is hard enough.
Surén P, Roth C, Bresnahan M, Haugen M, Hornig M, Hirtz D, Lie KK, Lipkin WI, Magnus P, Reichborn-Kjennerud T, Schjølberg S, Davey Smith G, Øyen AS, Susser E, & Stoltenberg C (2013). Association between maternal use of folic acid supplements and risk of autism spectrum disorders in children. JAMA : the journal of the American Medical Association, 309 (6), 570-7 PMID: 23403681Symonds ME, Mendez MA, Meltzer HM, Koletzko B, Godfrey K, Forsyth S, & van der Beek EM (2013). Early Life Nutritional Programming of Obesity: Mother-Child Cohort Studies. Annals of nutrition & metabolism, 62 (2), 137-145 PMID: 23392264Bringhenti I, Moraes-Teixeira JA, Cunha MR, Ornellas F, Mandarim-de-Lacerda CA, & Aguila MB (2013). Maternal Obesity during the Preconception and Early Life Periods Alters Pancreatic Development in Early and Adult Life in Male Mouse Offspring. PloS one, 8 (1) PMID: 23383269Pike KC, Inskip HM, Robinson SM, Cooper C, Godfrey KM, Roberts G, Lucas JS, & the Southampton Women’s Survey Study Group (2013). The relationship between maternal adiposity and infant weight gain, and childhood wheeze and atopy. Thorax PMID: 23291350