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Risk of Autism Rises With Age of Moms, Dads

Kaiser Permanente study of more than 132,000 children suggests link between chronic, life-long condition and advanced maternal and paternal age

Oakland, CA, April 2, 2007 — Men and women who wait to have babies later in life may increase their children’s risk for autism, according to a Kaiser Permanente study featured in the April issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

The study investigated 132,844 children born at Kaiser Permanente hospitals in Northern California over a five-year period (1995-1999) and identified 593 children who had been diagnosed with an autism spectrum disorder.

Study results show that a mother’s and father’s risk of delivering a child with autism steadily increases as they get older. Women ages 40 and older showed a 30 percent increase in risk for having a child with autism (1 in 123), when compared to moms between the ages of 25 and 29 (1 in 156). Men ages 40 and older had up to a 50 percent increased risk of having a child with autism (1 in 116), when compared to their 25- to 29-year-old peers (1 in 176).

Advanced age of mothers has been associated with risk of autism in several, but not all earlier studies, according to study author Lisa A. Croen, PhD, an epidemiologist at Kaiser Permanente’s Division of Research in Oakland, Calif. The role of a father’s age in autism has been less frequently studied, although advanced paternal age has been associated with other adverse reproductive outcomes, including miscarriage, childhood cancers, autoimmune disorders, schizophrenia and other neuro-psychiatric disorders.

“As men age, there is an increased frequency of new mutations in the cells that go on to become sperm,” said Dr. Croen. “These sporadic mutations could be related to autism risk. It is possible that non-genetic factors that are more common in older parents might also account for our findings.”

For reasons not fully understood, autism is on the rise, affecting on average about one in 150 children born in the U.S., according to the Centers for Disease Control and Prevention, which helped fund the study. The chronic, life-long condition affects the normal functioning of the brain, impacting development of social and communication skills.

While the cause of autism is unknown, there is strong scientific evidence that the condition is genetic. Environmental factors — such as infections, medications and pesticides — are also being investigated for their possible role in the cause of autism.

Children with autism are four more times likely to be male. According to the study, children with the disorder were also more likely to have older, more highly educated and white, non-Hispanic parents.

A growing number of autism cases several years ago caused Kaiser Permanente physicians and leaders from throughout Northern California to design a regional program that would best serve the needs of parents and children. Using best practices, the Regional Program for Autism Spectrum Disorders (ASD) was established in 2004 under the direction of Pilar Bernal, MD.

Today, the regional program includes a team of ASD clinical champions from all of Kaiser Permanente’s pediatric psychiatry and pediatric clinics in Northern California. It also includes two regional Autism Spectrum Disorders Centers, currently located in San Jose and Rancho Cordova. A third center is being planned for the Bay Area.

Research shows that early intervention can greatly improve a child’s development. Kaiser Permanente provides routine autism screening for newborns to age 2 during well-baby check-ups, allowing pediatricians to refer very young children to the regional centers who they suspect may have symptoms of autism.

Once a child is referred to one of the two regional centers, a multidisciplinary team of health professionals is responsible for evaluating and diagnosing the child, and developing and coordinating an individual treatment plan that covers all aspects of care, including medical, educational and developmental. The centers’ multidisciplinary clinical team includes child and adolescent psychiatrists and psychologists, developmental pediatricians, child neurologists, social workers, and speech therapists.

“Our regional centers work closely with our own local clinics, as well as community resources like school districts and appropriate public health agencies, to ensure that families and children have all the support they need,” said Dr. Bernal.

Clinicians at the Autism Spectrum Disorders Centers also collaborate on several autism research studies conducted by Kaiser Permanente’s Division of Research in Oakland, investigating risk factors, trends, treatments and outcomes.

The Kaiser Permanente Division of Research conducts, publishes, and disseminates epidemiologic and health services research to improve the health and medical care of Kaiser Permanente members and the society at large. It seeks to understand the determinants of illness and well being and to improve the quality and cost-effectiveness of health care. Currently, the center’s 400-plus staff is working on more than 250 epidemiological and health services research projects.

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