Asphyxia at Birth Merits Investigation as the Cause of Autism in Some Children
The brain abnormalities reported in some cases of autism can be
viewed as a variant of Wernicke’s encephalopathy: a bilaterally symmetric
pattern of damage involving subcortical nuclei and the cerebellum .
Wernicke’s encephalopathy is found in cases of chronic alcohol
intoxication and factors, like thiamine (vitamin B1) deficiency that
interfere with aerobic metabolism . Prenatal exposure to alcohol is
one of the co-morbid conditions associated with autistic disorder .
Maternal use of alcohol during pregnancy should be investigated in every
case of autism, as should use of all other drugs, like the anti-seizure
medication valproic acid .
Asphyxia at birth of 8 minutes or more produces a variant of
Wernicke’s encephalopathy with prominent damage of the inferior colliculi
in the midbrain auditory pathway ; asphyxia was inflicted
experimentally in monkeys by preventing pulmonary respiration then
clamping the umbilical cord. Monkeys allowed to survive several years
following asphyxia of even shorter duration developed a
“transneuronal”.pattern of pathology involving the cerebellum,
hippocampus, amygdala, mammillary bodies, corpus callosum, and temporal
and frontal lobe radiations  – areas of the brain affected in some
cases of autism .
Monkeys subjected to umbilical cord clamping and prevented from
breathing displayed a transient “hypotonic cerebral palsy;” they recovered
normal motor functions but remained hypoactive and were impaired in tasks
of short-to-long term memory function . Spastic cerebral palsy was
later produced in monkeys subjected to prolonged partial hypoxia during
gestation, which produced damage of the motor cortex long associated with
cerebral palsy .
Meconium aspiration was found associated with autism by Matsuishi et
al. . Meconium aspiration is suggestive of an asphyxic insult with
increased buildup of carbon dioxide stimulating respiratory attempts in
utero. Bodier et al. found autism associated most strongly with
complications at birth in cases without other co-morbid causes .
Complications at birth are associated with autism and merit as much
attention as genetic or other environmental causes . Immediate
clamping of the umbilical cord has become a standard practice . Could
this explain the increased incidence of autism? Hypovolemia and several
minutes of asphyxia can result if the cord is cut before an infant is
breathing on his own.
The auditory system of the brain is prominently affected by asphyxia
at birth, and this deserves investigation as cause of echolalic speech,
hyperacusis, verbal auditory agnosia, and the auditory attention
deficit disorder of children with autism .
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Competing interests: No competing interests