Studies Suggest Possible Role of Low Birth-weight, Preterm Delivery in Hyperactive Disorders

The fact that the dietary habits of mothers can impact the future health of their unborn children is no longer seriously doubted. Beginning with the first reports conclusively linking a reduced maternal intake of the B-complex vitamin folic acid with a higher incidence of neural tube defects (Yen et al, 1992), dietary habits of the expectant mother have been shown to cause other health concerns in the newborn (Fetal Alcohol Syndrome, Low Birth Weight/Preterm Labor among women who smoke during pregnancy, etc.).

Recently, several studies have appeared in the medical literature that further emphasize the importance of proper prenatal diet and other factors that may be of benefit in reducing the incidence of serious, long term pediatric health problems.

The most alarming of these studies appeared in the August, 2006 issue of the Archives of Disease in Childhood in which Karen Linnert and associates demonstrate an apparent link between preterm delivery, low birth weight, and the hyperkinetic disorders.

In this study, 834 clinically confirmed cases of hyperkinetic disorder in children were compared to 20,100 age-matched controls that were enrolled in the Danish Psychiatric Registry. The investigators found that children born between 34-36 weeks gestation had nearly twice the risk of hyperkinetic disorder, while those born before 34 weeks gestation had nearly triple the risk.

Infants born at term with birth weights between 1500-2499 demonstrated a 90% increased risk of hyperkinetic disorder. Those with birth weights between 2500-2999 grams had a 50% increased risk compared with normal weight infants born at term.

Although the study investigated relative risk only and did not pose an explanation for the findings, several reviewers were of the opinion that the relative vulnerability of the “dopamine axis” may be at least part of the explanation for the findings reported.

Another recently study by Graham Devereuax and colleagues at the University of Aberdeen (United Kingdom) suggests that there may be a link between low maternal intake of vitamin E and the presence of asthma in their children at 5 years of age.

This study is actually an extension of a previously reported evaluation of the relationship between maternal ingestion of antioxidants (vitamins C and E) and trace elements (copper, selenium, magnesium) and the presence of wheezing in the absence of “colds.” The initial report found that reduced Vitamin E consumption correlated with a higher incidence of asthma symptoms at 2 years of age and further that the frequency of asthmatic symptoms was not lowered by the child’s intake of any of these substances.

The more recent report is a continuation of the previously published report except that it demonstrates that the findings previously reported at 2 years of age seem to persist in children that are reexamined at 5 years. As in the first study, maternal vitamin E consumption appears to be the only variable that reduces the reported incidence of asthma symptoms. Both studies failed to demonstrate evidence that antioxidant and trace mineral consumption by the child had any effect on the underlying disease.

Comment

The results of the investigations mentioned above confirm what should be common knowledge (if not common sense): actions of the mother in the prenatal period will, more often that not, eventually have an impact of their child’s health. These reports are in no way to be considered as all-inclusive simply because the medical literature seems to contain more and more reports of possible beneficial or harmful effects from a wide variety of substances. The operative word here is, of course, possible.

As is often the case with initial studies, these reports are based on relatively small populations drawn from relatively small areas. This may mean that the studies reported may either overestimate or underestimate the incidence of the disease being studied and/or the causal relationships put forth as possible contributing factors.

A second point that must be stressed is that can does not transliterate to will and that possible in not a synonym for always. The history of medicine clearly demonstrates that most “revolutionary” results will either be moderated by further research if not totally discredited.

The moral of the previous 2 paragraphs is this: take all that you read with several grains of salt. Do not “hop on the bandwagon” of some new treatment or newly identified cause of some condition. And above all, never use incomplete or untested theories as an excuse for your own irresponsibility.

Literature Consulted

Centers for Disease Control and Prevention. Alcohol Consumption Among Women Who Are Pregnant or Who Might Become Pregnant – – United States, 2002. MMWR 53(50); 1178-1181.

Devereux, Graham et al. Low Maternal Vitamin E Intake during Pregnancy Is Associated with Asthma in 5-Year-Old Children. Am. J. Respir. Crit. Care Med. 2006; 174: 499-507.

Kurtzweil, Paula. “How Folate Can Help Prevent Birth Defects.” FDA Consumer; July, 1996. Revised February, 1999.

Linnert, K. et al. Gestational age, birth weight, and the risk of hyperkinetic disorder. Archives of Disease in Childhood, 2006; 91:655-660.

Martindale, S. et al. Antioxidant Intake in Pregnancy in Relation to Wheeze and Eczema in the First Two Years of Life.

American Journal of Respiratory and Critical Care Medicine 2005 Vol. 171. pp. 121-128.

Ventura, S. et al.Trends and Variations in Smoking during Pregnancy and Low Birth Weight: Evidence from the Birth Certificate, 1990-2000.Pediatrics; Vol. 111 No. 5 May 2003, pp. 1176-1180.

Yen IH, Khoury MJ, Erickson JD, James LM, Waters GD,

BerryRJ. The changing epidemiology of neural tube defects: United States, 1968-1989. American Journal of Diseases of Children 1992; 146:857-861.

Disclaimer

The information presented in this article and its included links is of an informational nature only and is not intended as a recommendation of any changes in the reader’s health care program. Before making any changes in diet, medications, or other treatments the reader is strongly advised to consult with their health care provider.

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