US President Donald Trump sparked outrage last week by claiming paracetamol taken during pregnancy was fuelling a spiralling autism ‘crisis’.
International scientists immediately dismissed his comments as ‘fear-mongering’, stressing there is no evidence the painkiller raises the risk of the disorder.
However, others say while it is unclear whether paracetamol causes autism – a condition that makes it difficult for people to understand social cues and express themselves – something is clearly driving the increase in cases, with one in 100 now affected.
And a growing number of experts believe they may have identified a major risk factor: a pregnancy complication called gestational diabetes.
The blood-sugar disorder, which is often symptomless and linked to obesity and older mothers, now affects at least one in 20 expectant women.
A landmark review of 48 studies, involving more than nine million pregnancies, found that women who developed it were almost 60 per cent more likely to have a child diagnosed with autism.
Researchers stress that the condition has no single cause: it arises from a mix of genetics and environmental influences.
Many also warn that focusing on risk factors can fuel stigma by implying that mothers are to blame, when, in reality, autism is nobody’s ‘fault’ and any single influence is only part of a much bigger picture.
Still, the review is among the clearest signs yet of a lifestyle-related – and potentially preventable – factor behind autism.
The study, presented at the European Association for the Study of Diabetes, also found that children of mothers with gestational diabetes were 36 per cent more likely to be diagnosed with attention deficit hyperactivity disorder (ADHD) – another condition that has rocketed in recent decades. Exposure in the womb also raises the chances of a baby developing foetal macrosomia, or ‘giant baby syndrome’, in which infants are born far above average size.
Gestational diabetes, which is often symptomless and linked to obesity and older mothers, now affects at least one in 20 expectant women
In recent years, mothers of macrosomic babies have gone viral on social media, proudly sharing pictures of their enormous newborns with millions of view (see right).
But doctors warn there is a dark side: these babies are more likely to suffer shoulder fractures and nerve damage during delivery and face higher risks of obesity, diabetes and breathing problems later in life. They are also at greater risk of stillbirth.
Yet despite the growing threat of gestational diabetes, experts say the NHS is still missing too many cases, leaving thousands of women and their children in danger. Too few women are tested, they argue, and even when they are, the standard blood check can give false reassurance, wrongly suggesting that some mothers are in the clear.
Studies show that, caught early, the condition can be easily treated and serious complications avoided.
Dr Dimitrios Siassakos, professor of obstetrics at University College London, says: ‘Gestational diabetes is causing a lot of preventable harm to mothers and babies and too many patients are going undiagnosed. With the number of cases on the rise, the NHS needs to reassess how it tests for the condition soon.’
So what is it and how can it be prevented?
Gestational diabetes affects about one in 20 women in the UK, charity Diabetes UK says, although some experts claim the figure may be higher due to the number of cases that are missed.
It occurs when the body cannot make enough insulin, the hormone that regulates blood sugar, to meet the extra demands of pregnancy. This can cause sugar levels in the blood to shoot up, damaging organs in the body.
Gestational diabetes can happen at any stage of pregnancy. However, it is more common in the second and third trimester.
Crucially, it is more common in women who are obese and those over the age of 35. Experts say these factors are behind the rising number of patients with the condition. Studies show that the average expectant mother is now older and more overweight than two decades ago.
And it can have disastrous consequences for the unborn child.
Research shows gestational diabetes can alter hormone levels during pregnancy and, in turn, impact a youngster’s brain development. In fact, some experts argue that the condition could be the real reason why women who take higher than normal amounts of paracetamol appear more likely to have children with autism.
Dr Siassakos says: ‘The study that US health officials claim proves paracetamol causes autism did not check how many of the women involved had gestational diabetes.
‘When you have diabetes, you’re more likely to suffer infections that lead to a fever, which women are encouraged to treat with paracetamol. So it’s possible that the reason these women go on to have children with autism is gestational diabetes rather than the paracetamol itself.’
Gestational diabetes can also affect women and children later in life. About half of women diagnosed with the condition will go on to develop type 2 diabetes, a chronic form of the disease. Children born to mothers with gestational diabetes are twice as likely to be obese.
This quadruples their risk of getting type 2 diabetes by the age of 25. And studies show that patients diagnosed with type 2 diabetes by the age of 30 see their life expectancy fall by 14 years on average.
Experts say gestational diabetes is also one of the leading causes of deadly birth complications.
Dr Siassakos says: ‘When doctors examine the placenta of stillborn children, one of the most common findings is undiagnosed gestational diabetes.
‘We also know that raised sugar levels increase the size of babies, making births more difficult for the mothers and increasing the chances of things going wrong.’
But the NHS does not test all pregnant women for gestational diabetes. Instead, it offers a blood sugar test to a limited number of patients who are considered at risk
But despite these risks, the NHS does not test all pregnant women for gestational diabetes.
Instead, it offers a blood sugar test, usually at 24 weeks and 28 weeks of pregnancy, to a limited number of patients who are considered at risk. These include those with a BMI above 30 before pregnancy, previous babies weighing more than 10lb (4.5kg) at birth, gestational diabetes in a previous pregnancy, a close family history of diabetes or certain ethnic backgrounds.
But experts say the test should also be offered to those whose babies appear larger than normal on scans, as it is a reliable indicator of gestational diabetes. Dr Siassakos says: ‘High sugar levels will mean the baby grows more quickly. So if at a 24-week scan the baby’s tummy size is noticeably larger than normal, then doctors should offer the mother a gestational diabetes test.’
Some medics believe that women should also be tested earlier in pregnancy. This is because the majority of brain development takes place in the early stages of pregnancy.
Dr Siassakos says: ‘In many other countries, pregnant women are tested at 16 or 18 weeks. But we only offer that to women with a previous history of gestational diabetes. In an ideal world, all high-risk women should get the test at this stage, but the NHS doesn’t have the resources for this right now.’
Another concern is that many high-risk women are wrongly told that they do not have gestational diabetes because of issues with the test used by the NHS.
Currently, patients are told to fast overnight before the test. They give a blood sample in the morning and then drink a sugar solution. Two hours later, they take another blood test. If the check, which is called an oral glucose tolerance test, shows raised sugar levels two hours later, this is considered a sign of gestational diabetes.
But research shows this test can be unreliable.
Dr Siassakos explains: ‘Many women with gestational diabetes, particularly in the early stages, will produce just enough insulin to bring sugar levels down within two hours.
‘What we should be doing is testing patients after one hour. That way fewer cases would be missed.’
One patient who struggled to get a diagnosis of the condition is Estella Newbold-Brown, 43, who gave birth to twins five years ago.
The south London lawyer, at Amphlett Lissimore Solicitors, says she ate healthily during her pregnancy and was a normal weight. A blood sugar test at 24 weeks, taken because of her age, appeared to show no signs of diabetes. But another several weeks later revealed raised sugar levels.
Estella says: ‘The doctors still couldn’t decide among themselves right up until the birth whether I had diabetes or not.’
She suffered a number of complications during her pregnancy, including pre-eclampsia as well as liver and kidney problems. And one of her children was born above average size.
Estella says: ‘I’ll never know whether I had diabetes or whether the complications had anything to do with this. But I have a friend who was diagnosed with gestational diabetes fairly early on in her pregnancy and she was given specific changes she needed to make to her diet.
‘If I’d got a more thorough diagnosis, maybe I could have benefited from this sort of advice.’
Experts say there are steps that patients can take to combat complications once diagnosed. While there are blood sugar-reducing drugs which can be prescribed, such as metformin, research shows diet and exercise changes are the most effective treatments.
Dr Siassakos says: ‘Four or five hours of exercise a week that gets your heart rate up is all you need. You don’t need to run a marathon. Just speedy walking will do it. This should be achievable even for pregnant women.
‘A diet that is high in fibre and low in carbohydrates, sugar and saturated fat will also make a big difference.’
And women don’t need to wait until a diagnosis to make these changes.
‘These are lifestyle improvements that all pregnant women should make,’ he says. ‘The best way to prevent the complications of gestational diabetes is to stop it from developing in the first place.’
…AND IT IS BLAMED FOR THE WORRYING RISE OF GIANT BABIES
It’s the latest parenting craze on social media – mums proudly posting clips of their little ones and viewers gushing over their ‘chunky rolls’ and ‘cute’ features.
Six-month-old Gianna weighs 2st 3lb (14kg). She was 11lb (5kg) at birth
But this isn’t the usual battle of who has the cutest baby. These are children who share something that is far more surprising: they’re enormous.
Under the hashtag #BigBaby, the trend has drawn tens of millions of views as parents reveal their infants’ off-the-charts measurements.
In one video, Australian mum Shanna shows off her 2st 3lb (14kg) six-month-old daughter Gianna. Shanna adds that Gianna was 11lb (5kg) at birth.
It’s thought that one in ten children in the UK are now born weighing over 8lb (3.5kg). These children are considered to have a condition known as foetal macrosomia, or giant baby syndrome. Experts say the condition is linked to gestational diabetes.
‘Women with untreated gestational diabetes are much more likely to have big babies,’ says Prof Dimitrios Siassakos.
Research shows that babies born with foetal macrosomia have a significantly raised risk of birth complications as well as diabetes later in life.
This article was originally published by a www.dailymail.co.uk . Read the Original article here. .