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Ultrasounds and autism. Thoughts?
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Anonymous
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http://iacc.hhs.gov/events/2010/slides_caroline_rodgers_102210.pdf
Interesting. Never heard of it before. |
Anonymous
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http://www.blisstree.com/2007/01/20/mental-health-well-being/sure-theres-an-autism-epidemic-but-watch-your-words/
Rodgers’ question here is rhetorical; her thesis is indeed to make a case for ultrasound as a potential cause of autism. But correlation does not imply causation. Rodgers does not take into account the changes in the criteria for autism in the DSM-IV in 1994, changes which significantly broadened the criteria for an autism diagnosis, and, indeed, the evoluation of our understanding about autism from the time Leo Kanner first described what he called “infantile autism.” Like Michael Waldman’s theory that TV causes autism (which fueled some fervid discussion in Autismland), the suggestion of a link between autism and ultrasounds is a finding without a theory. Read more: http://www.blisstree.com/2007/01/20/mental-health-well-being/sure-theres-an-autism-epidemic-but-watch-your-words/#ixzz2WZVX2ggR |
Anonymous
| Who is Caroline Rogers? What are her credentials? |
Anonymous
| I think she needs to make a stronger case than lots of circumstantial evidence, especially considering that the one prospective, longitudinal study she cites (this one: http://www.sciencedirect.com/science/article/pii/S0140673604175168) didn't know any negative effects of ultrasounds on long-term development. |
Anonymous
| ^^ Oops: know should be show |
Anonymous
I didn't know the exact dates, but this was my thought as well. We're trying to blame all of these outside factors on this "boom", but maybe it's not actually any more prevalent- just being diagnosed more and is easier to identify, and as you said, now has broader criteria fro diagnosis. |
Anonymous
Seems to me that she's making the case for more research not that anything is proven. There is very little research in to the long term effects of repeat and frequently unnecessary ultrasounds. That's one reason why I am not in favor of them. |
Anonymous
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I try not to comment unless I've read the article. I haven't, so I'll limit my remarks to this. Ultrasounds seem very safe. As with EVERYTHING in pregnancy, they rely on the lack of adverse reports and animal studies to show whether or not something is harmful in pregnancy. Because the evidence is so limited, the FDA and other regulators / health agencies say that ultrasounds have an excellent safety track record, but should be used prudently, even for diagnostic purposes.
With my first, I had ultrasounds with every single OB visit. I remember seeing some posts on these boards about the safety and thought those women were wearing tin foil hats. Since then, I've read more about this, thanks to friends in Canada where ultrasounds are much more sharply limited (they usually have ONE, at 20 weeks, and no more, due to the unknown risk factors) and have learned that researchers know a few things: 1. In rats, which are not unlike humans, ultrasounds at doses akin to what a normal pregnant human mother gets, heats up the cells of the fetus and impacts / changes the way the fetus is developing. Some harm has been shown. Again, in rats. 2. In humans, we know that ultrasounds do heat up and disturb the cells. The effect of this on the fetus is not fully known, but no evidence of harm has ever been shown in humans. 3. Generally, ultrasounds give so much useful information that the unknown potential risks are deemed acceptable given the benefits. I think number 3 is where I get hung up. What do we get from an ultrasound? We get dating, if that is unknown. So if your LMP and ovulation dates are wildly disparate or you don't know them, this can be useful. Or if you do not know your LMP, this can help. Additionally, ultrasounds give us reassurance. That our baby is alive (in the early weeks) and likely to be chromosomally normal (12 week NT scan) and with healthy brain and heart development (20 weeks) and then later, we can see placenta and baby positioning. ULtrasounds are used for other things, of course - to check on the uterus for problems, to size baby (controversial) and other things. Each woman and doctor ought to, to my mind, be giving thoughts to what HER benefits are. For example, if you are not likely to terminate a baby with a chromosomal problem and don't feel that knowing about a problem ahead of time is useful, it may make sense to skip that NT scan. If you can live with some uncertainty in the early weeks and trust that things are fine, and you know your dates, it may make sense to skip the 8 week u/s. The 20 week u/s feels very important to me, since some of the things they find then CAN be addressed in utero. Likewise, if you fear placental degradation, this could be vital. But most good providers can tell where a placenta and baby is without a scan, so the later u/s can in many cases be skipped. The threshhold for offering ultrasounds has turned from once a pregnancy to about four per pregnancy, standard. While I think they are a useful tool, I question (for me) whether these are necessary. Unlike my last pregnancy, with this pregnancy, I've made it clear I want only the 20 week scan unless there is a clear medical indication for additional scans. |
Anonymous
Very well said |
Anonymous
| Can anyone meaningfully compare ultrasounds with dopplers that they usually use at every visit to obgyn? |
Anonymous
| This is interesting, and it does seem like it's probably an area worthy of more research. |
Anonymous
| If ultrasounds were the culprit then you would see a huge raise in Autism rates for women with high risk pregnancies and IVF where you get many more ultrasounds than the average pregnancy. Esp. with IVF and all the early ultrasounds during the most critical period of development. I couldn't even tell you how many I had with my high risk pregnancies - but at least one every 2 wks and with no issues. |
Anonymous
Thanks, pp, I needed that! I was going to say, if u/s really is a problem, we're screwed because we had several due to my high risk situation. I agree that you shouldn't get a gazillion if you don't have to, but in my case it was necessary. |
Anonymous
I don't think you understand research. You might see a "huge raise" or you might, more likely, see a slight rise. Most issues happen incrementally, and if the cause were this obvious, we would not need to study things carefully. Indeed, some of the things that "seem" obvious (ie "huge increase" in autism diagnosis right after MMR vax) turns out to be coincidence. While there are often big red flags and seemingly obvious correlations, most of the time, cause and effect is more subtle, can have multiple compounding factors, etc. I also had about 15 or more ultrasounds with my first pregnancy, and that does not include the doppler use, and no autism. But N does not equal 1, ever. You need to look at effects over populations, taking care to control for other mitigating / compounding factors. I don't think anyone is saying that ultrasounds clearly cause autism, merely that this is something that deserves a closer look. It is my belief that ultrasound safety, in general, requires further study to justify (for most women, not going to be the same for a high risk woman) the number of ultrasounds given. This is something that every medical authority agrees with, by the way. While u/s technology has a strong safety track record, it like most things, is not proven to be safe, and a sufficient number of concerns (not related to autism; other concerns) exist based on animal studies that while we think it is safe, judicious use is recommended. so nobody is saying that the high risk woman who faces placental degredation, abruption, vasa previa, etc, should forgo ultrasounds based on research that merely says we should do more research...but....the "routine" ultrasounds with more limited benefit may deserve more careful scrutiny than they are getting. Any time you change a policy or highlight a problem, you potentially cause guilt or remorse over the way things were done previously, or what you should have done differently. I feel this way about my first pregnancy, with all of its monthly then weekly ultrasounds. But, I don't think that should ever stop us from talking frankly about what might be contributing to risks. BTW, experts now feel very strongly that autism has both a genetic AND environmental component, and we also are starting to look at epigenics (not just older fathers, but especially older fathers who have, themselves, older fathers). It is, unfortunately, not so simple as expecting to see a "huge raise" in autism associated with high risk pregnancies. |
Anonymous
That is a good question. According to her, she is a writer and "researcher" with no documentation on what her actual credentials are. She posted this article in 2006 on "Midwifery Today," with the description that she specializes in "Caroline Rodgers is a writer/researcher who has a special interest in the impact medical diagnostic imaging has on human biology." It sounds like she likes to pull "facts" together to make a hypothesis. See here on dental x-rays and dementia: http://aspe.hhs.gov/daltcp/napa/Comments/cmtach34.pdf OP, please don't post moronic stuff like this. I love the way she glosses over pesticides and pollution by cherry picking vague facts. |