Saturday, January 2, 2010

Oxygen Deprivation

In a 2005 study, rat pups were deprived of oxygen for as long as ten to twelve minutes during birth (by increasing the level of nitrogen in the air).  As they grew older, the oxygen-deprived rats showed autistic-type symptoms, including delayed or disrupted reactions to sound.  The study suggests that there may be a correlation between oxygen deprivation at birth and autism later in childhood.

I became aware of this study after reading through a fascinating thread on an ASD message board on Circle of Moms.  Dozens of women were discussing the difficult births of their autistic children - umbilical cord strangulation, unusually quick deliveries, emergency c-sections - that all included oxygen deprivation.  Obviously this is not a scientific sample, and I'm sure you could find lots of autistic kids who were not deprived of oxygen (and suffocating newborns who never developed any special needs).  But I'm really into the idea that there may be some sort of connection between poor air supply and early brain development.

Are we seeing more diagnoses of ASD these days because doctors are better able to keep struggling newborns alive than they were 20 years ago?  Could it have something to do with the modern medical practice of clamping off the umbilical cord too soon after birth?  Apparently, although blood continues to pulse through the cord for about 5 minutes after birth, doctors often clamp it off after 30 seconds to a minute, thereby cutting off the newborn's oxygen supply before his/her lungs are 100% functional.  This can lead to birth injuries such as cerebral pasly, retardation, learning disabilities, and autism.

So, in the interest of totally non-scientific inquiry, I pose this question to you, Dear Reader:  was your child somehow deprived of oxygen at birth, and do you consider your child neurotypical or somehow challenged?  I'll start: Ryan wasn't breathing at birth, and has PDD.

Discuss.

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An addendum: I wrote a note to the researchers on the Interactive Autism Network project, and Dr. Connie Anderson wrote the following in response:

"So far, various researchers have found some slight associations between autism and various pregnancy and birth related factors. In a recent article on the epidemiology of autism, Newschaffer et al wrote, 'Uterine bleeding, Cesarean section, low birthweight, preterm delivery, and low Apgar scores are among the few factors that have been more consistently associated with autism... Methodologic issues continue to challenge the synthesis and interpretation of this body of evidence. The underlying cause of a measured obstetric factor or set of factors is rarely known, nor is the temporal relationship between the obstetric event and the actual biological onset of autism.' (The Epidemiology of Autism Spectrum Disorders, Annual Review of Public Health 2007, Vol 28, pg 244)

"In brief, there have so far been some associations found, but little is still little understanding of whether they are cause or effect or how they even relate to autism's onset."

28 comments:

  1. I suggest you do an informal poll among former preemies who are OFTEN deprived of O2, not only at birth but also during all the apnea spells and desats. I'll let you know what happens with D.

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  2. Hannah had a normal delivery, but contracted herpes in utero from her birth mother and tested positive for it at birth. She had Asperger's and SPD. She also had to have a spinal tap a week after birth and one of Hannah's former therapits is actually doing a research study on the corelation between early lumbar punctures and SPD because as a therapist she has seen a huge amount of ancedotal evidence to suggest there might be causation or at the very least a strong correlation. So, when she went back for her doctorate that's what she began studying. She's still in the very early stages of her research though so there's nothing to report abou it yet.
    Natalie

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  3. Hannah's birthmother also had a stressful pregnancy. She had severe asthma and was hospitalized more than once for bad asthma attacks while pregnant. She was hiding the pregnancy from many of her family members. She was on the outs with Hannah's birthfather. AND she was preparing to place Hannah for adoption.
    Natalie

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  4. Hi there-I found your blog via Casdok/Faces of Autism and took some time to read some of your older posts. I really appreciate your viewpoint on autism and your honest writing. I have two boys, the youngest (3.5)is diagnosed with autism and my older son (5) has sensory issues, social issues and his teacher has suggested possibly Asperger's...we are in the midst of all of that.

    My older son had the umbilical cord around his neck prior to birth and had significant drops in heart rate with contractions. His arrival beyond that was normal, but I have wondered if that affected him at all. He was incredibly verbal at an early age and has extraordinary visual-spatial ability for his age, but extremely rigid in routine and has lots of social issues because he needs the rules to be followed. He is also extremely sensory-water, dirt, etc. All that said, I do notice that he has a lot of the same qualities as some of my family members, so I do think genetics is a part of the equation too.

    Sorry to be lengthy-but it was nice to visit!

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  5. I was deprived of quite a bit of oxygen (and turned blue several times) during birth and infanthood. I still have respiratory problems (I have BPD) but I am "neurotypical." ( was 3 months premture).

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  6. An addendum; I wrote a note to the researchers on the Interactive Autism Network project, and Dr. Connie Anderson wrote the following in response:

    "So far, various researchers have found some slight associations between autism and various pregnancy and birth related factors. In a recent article on the epidemiology of autism, Newschaffer et al wrote, 'Uterine bleeding, cesarian section, low birthweight, preterm delivery, and low Apgar scores are among the few factors that have been more consistently associated with autism... Methodologic issues continue to challenge the synthesis and interpretation of this body of evidence. The underlying cause of a measured obstetric factor or set of factors is rarely known, nor is the temporal relationship between the obstetric event and the actual biological onset of autism.' (The Epidemiology of Autism Spectrum Disorders, Annual Review of Public Health 2007, Vol 28, pg 244)

    In brief, there have so far been some associations found, but little is still little understanding of whether they are cause or effect or how they even relate to autism's onset."

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  7. I won't fit your profile or perhaps I would be an outlier. Morgan had to go to ICU when born for lung reasons due to merconium (sp?) As you know, Meredith, she is in an advanced academic school and seems to be a normal (whatever that means)kid. However, it seems to be a great theory. Since I am pregnant again. I will be sharing this with my dr. Thanks!

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  8. Hallie, who is 3.5, was born over 4 months premature and had virtually no lung development at birth. She experienced hypoxia quite often during those early months in the NICU, needed lots of ventillation, occasional chest compressions, turned blue a few times, etc. She was diagnosed as having High Functioning Autism at age 3, and has lots of sensory processing issues. I know that they have found a greater instance of autism among preemies and that it hits girls particularly and disproportionately hard. I don't know whether they are studying the relationship between this and hypoxia, though. But it sounds like it would be worth prusing.

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  9. My Autistic Son was the best delivery our of my 5. There was no oxygen issues at all! I feel strongly that for my son, it is related to neurology and comes from my Husband's side. My husband was a lot like my son is when he was a child. I think for us at least, that genetics are the determining factor for his Autism.

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  10. My son is 15. He was overdue by almost 2 weeks and blue at birth with the cord around his neck. Needless to say his Apgar scores were 1-2 and I thought he wouldn't live. But he was resusitated and monitored by a public health nurse for the first year of life. All seemed well but in second grade it was determined he had a learning disability, a lack of depth perception and problem with auditory processing. All these things were addressed in school and he received help. Now as a teenager he seems to have trouble forming friendships...He is very polite, good natured, has a job, attends church youth group. But I am concernd about him socially. He is becoming a loner yet doesn't want to be. He meets some of the criteria for AS but I have always felt that time without oxygen has been a factor in his development. Any one with a similar story?

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  11. I am very interested in this idea. Of course if the brain is starved of oxygen it has to have a long term effect on cognitive power. I'm really unsure about the genetics side of things.....if one parent is strong cognitively and the other one is weak cognitively then how does the child fare out? I'd really love to hear peoples opinion on this.

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  12. You bet the correlation exixts. Research dollars don't get spent on confirming this correlation because there is no money in it for physicians, only potential lawsuits from aggrieved parents over their brain injured children. Here is my personal story. My son is a survivor of a full term complete placental abruption at 39 weeks. He was as close to stillborn as possible, with an initial APGAR of 1(only vital was a HR of 60BPM and falling). It took 15 minutes to resucitate him, and he was on the ventilator for the first twenty four hours. We were sent home from the NICU after four days because he was eating normally and had no seizure events. His behaviour was abnormal from the beginning. He screamed constantly, and started banging his head against things as soon as he could hold it up. Now at six, he is dx as a high functioning autistic, and has serious cognitive deficits, sensory issues, and nighttime seizures. The clueless practioners we see tell us it's all genetic, and suggest a round of genetic testing(follow the money). At this point, I could care less about any further testing, he is a wonderful little boy and we are blessed to have him in our life. Just make sure you don't let ANY doctor tell you oxygen deprivation has no correlation to autistic like injury or behaviours, because they are FLAT OUT WRONG.
    A Dad

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  13. My son turned blue and had to be put under an oxygen hood at birth and stayed in the ICU for a week. He was also severely jaundice. He does not have full blown autism but has high functioning aspergers. Very sensitive to sound and texture. He does not catch onto social cues and is VERY bright.

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  14. My son was born 10 weeks early, c-section. I had pre-eclampsia. He was a "grower/feeder" in the NICU for 7 weeks and released. He has high-functioning Autism. Diagnosed at 3 but when the first therapist saw symptoms he was 11 months. Later therapists made notice that his most severe symptom is similar that of a stroke patient. Example- Hold an apple in your hand and speak with him he say "May I have the apple?" but ask him what your holding and he can't remember. At 5 now, He knows a lot and expresses a lot but can't perform "on-demand". He also has sensory, vestibular, social, and stiming ASD symptoms. I began looking at oxygen and Autism when I noticed him behaving very typical towards the end of nebulizer treatments at the end of a cold. I wonder... Does his brain require more oxygen than a typical brain? I can also see a possiable genetic cause in mine and his fathers families. Just another story to add.

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  15. I have read the above comments with interest as I have 2 year old twin girls, one of whom was starved of oxygen at birth due to the med staff not believing me when I said I had given birth (they were trying to give me an epidural at the time so I was in the sitting position and being held still by a midwife to stop me from moving). I estimate after I had given birth that I was made to sit there for between 7-10 minutes as they had problems inserting the needle into my spine, whilst all the time I was near hysterical as they said it just 'felt' like I had given birth. I eventually managed to knock the midwife away from me and fall sidewards, as my daughter was able to slither out. She was dead at this point, suffocated and I saw a complete panic as she was whisked away and I counted 10 med staff in the room, many surrounding her trying to resusitate. The twins were born 10 weeks prematurely and spent the first two months in neonatal with no problems other then having to grow. Twin two had had no problems in her developemental, whereas darcie has been delayed in every aspect. She started walking 14 months after her sister, started crawling late, sat up late etc. Now at age 2 and a half, she's been diagnosed with severe autism. As yet she does not speak, does not function as other 'normal' children. She's a beautiful, happy little girl and its no use being angry because life is how it is. But in my case I have no doubt that if the medical staff had actually listened to me when I said I had given birth instead of being left to suffocate, Darcie wouldn't be as she is now. Autism is such a wide spectrum but in this case just equates to being brain damaged due to oxygen starvation due to negligence.

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  16. Mom of Twins - what a tragic story. Best of luck to you all!

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  17. I had oxygen deprivation at birth and my parent did nothing about it. In school I struggled horribly and socially and this continued into my twenty's where I am now viewed by others as unsocial. Also, I have not been able to hold a job because I have difficulty learning new material. It took until I was 25 before i put two and two tegether realizing that my intelligence has been effected from trauma at birth, and this has been a most depressing realization. Since I was 16, I have suffered from severe depresive disorder, being hospitalized on 7 occassions. But I now realize that the depression is largely a result of my inability to function in society. I even got ect treatment (big mistake) because all the doctors had told me that my inability to concentrate and learn was due to being severly depressed. Now, I realize why the anti-depressant medications have not worked - the root of my problems lies in brain damage caused by oxygen deprivation at birth, the depression arising from the tremendous difficulties involved in performing daily life tasks. I am 26 now, and have been married for three years. I am also jobless and on disability. I have a hard time accepting that I am mentally handicapped. Any advice?

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    1. I can tell by your writing that you are smarter than half the people I know.

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  18. Anonymous,
    I also had oxygen deprivation at birth and have experienced the same problems you have. I am 27 years old, and have just recently met a doctor who believes in my theory of brain damage due to oxygen deprivation. I struggled emotionally, academically, and socially throughout school. I was able to "get by" due to my photographic memory, however, this only worked for me for a short time. Eventually, my memory began to fade. I ended up finishing school and went on to college where I received a Bachelor's Degree in Computer Science. Due to my inability to cope mentally, emotionally, and socially, I find myself hating life and myself. I am the mother of a four year old child and feel that he has surpassed me in many ways. I am having a very difficult time with my new job as I get bored very easily, have a terrible short-term memory, and several learning disabilities. It is not impossible to surpass the odds, but it is an up-hill battle all the way. My husband has a Ph.D. in Physics and does not understand my short-comings. He only think that I am lazy, and have no drive. Even after all of this, I suffer from severe depression, inability to absorb new information and problem solve. Sometimes I feel as if I should check myself into a Mental Institution and give up but then I think about others who have it far worse than me. I find that it is often more difficult to cope with mental problems, because they are internal and only those you wish to see them will. Please do not label yourself as "mentally handicapped." There is potential in all of us no matter what our circumstances are.

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  19. I have twins. One of my twins (a boy) suffered oxygen deprivation at birth. He is now 7 years old and has been diagnosed with PDD. He struggles in school with writing and reading and socially with making new friends. His young life has been a constant struggle because of his disablility. Thank you to anyone who has written a post on this subject. It is helping me to understand what challenges my son may face and how I should work on things for the future.

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  20. I`m a 45 year old male, that has suffered my whole due to my umbilical cord wrapped around my neck at child birth. I am fortunate to have had exceptional genetics with intellect that compensated somewhat for this I nonetheless have struggled with short term memory loss , difficulty concentrating, bad relationships and social phobias. With effort on my part I have overcome some of theses obstacles and continue to reinvent how to compensate for it.

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    1. you sound like my son, he's in middle school now, but struggles all the time with personal relationships, friendships, reasoning skills, memory issues, understaning, remembering and implementing rules into his life, concentration issues. . etc. Any advice for him. . .this is wearing down him self confidence and the doctors and therapists are of little help for us. . . thanks!

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  21. Two children, both oxygen deprived at birth. One PDD, one "Normal". PDD child had uterine bleeding, the other had his cord wrapped around his neck 3 times. perhaps it isn't one singular factor that causes autism but rather a sequence- genetic markers being one of them, oxygen deprivation another, I heard of some studies that pointed to birth order as well (usually first born)

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  22. yes, pre, oxygen deprived, no history of autism.. i think it was mishandling of doctors to force prematurity

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  23. My son was post dates, he was 16 days past his due date. I had told the doctors that he was going to be a very large baby, a mother just kinds knows somethings. They laughed it off as firt time mother jitters, did an unltrasound and told me he would be about 8 lbs tops. He became stuck (shoulder dystocia) during birth, his heart rate dropped, and a nurse jumped on top and straddled my stomach while pushing down on my stomach while another one pulled him by his head, they treated it as an emergency situation. He was pulled out bruised and his face was purple in birth photos. He was 10 lbs 6 oz and 21 3/4 inches long. . . big like i had told them, too big for me to have safely birthed vaginally like i tried to tell them. I hemmorhaged quite badly, had to have 3 shots of medicine and abdomonal massage to stop the bleeding, and almost passed out, my first views of him were of him seen from my eyes in double / triple spinning vision, the doctors handed him to me immediately anyway, i had to ask them to take him for me b/c i thought i was going to drop him and things were looking darker. after this i slept for hours while he was in the nursery. A doctor came to tell me he had been taken to icu b/c his blood oxygen levels were low, but she assured me he was fine and not a big deal . . .still weak from the hemmorhage i passed out asleep. When i awoke i went down to see him, i tried to nurse him and he wouldn't latch on right, he seemed disinterested in me. As a baby and toddler he was extremely fussy, not cuddly, hyperactive, and very sensitive to noise, and light. As he became school age he showed signs of difficulty with learning certain things, his motor skills ar behind, his social skills are behind, he doesn't make close friends, just acquaitance. He used to hear and see things "in his brain". Now his is in the 2nd percentile on some math skills and his highest math skill ranks at the 56th percentile. He's aggressive and responds inappropriately to many events, laughing at sad things, crying at the drop of a hat. . . he's in 6th grade now, but plays better with kids in 4-5th grade. On the surface he seems pretty normal at first, but after spending time with him you realize something is "off". Doctors and therapists have been unable to give me a diagnosis, they've said everythignn from tourettes, to ADD, to bi polar,. . .until finally a therpaist told me she didn't know what was going on with him. I just recently have read post like this that give me hope that i will find answers, the powerlessness that comes with not knowing is horrible. Although he now moves, runs, and generally acts like other kids like i said, there is a very large part of him and his behavior that is not, and i fear never will be "normal" per say. Sorry so long, that is our story and i absolutely believe after some of the reading i've been doing today that this is related. I just want to konw how to help him, he even recognizes the difference in him and other kids his age. So sad. I asked for a c-section also and the refused me more than once, also asked to be induced earlier than i was b/c of my concern about his size.

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  24. I'm so sorry there are so many stories like this. Thank you for sharing them here.

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  25. Hi, I accidently came upon this blog and will share my story. My grandson was delivered on time, but during the delivery, the doctor, while probing, puctured the placenta causing the baby to go without air for 15-17 min. They immediately sent the the baby via life star to another hospital where they packed him in a "cold blanket" to stop any further damage. Poor little guy, all those tubes and machines, I've never felt so helpless. He is now 13 months old, and to see him walk and interact, you would never know anything happened. My son and daughter in law, I found out today, are teaching him sign language mommy and daddy stile, anticipating a speech problem down the road, so they are doing what they can now to help him communicate later. He is alert, responsive, follows instruction and does everything normally, and is super happy, just amazing to watch. I can't believe that something bad will develope here, nor am I nieve, just very positive! All comments welcome, good or bad, thanks!

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  26. Hello, i also came upon this blog accidentally. My son is almost 5. When i was induced with him i was exactly one week overdue, i had absolutely NO problems with my pregnancy at all, None. They broke my water at 8:20am,sometime during labor, i can't remember the exact time ( i had Pitocin & an Epidural) they told me he wasn't getting enough Oxygen, they place a Oxygen mask over my nose and mouth and told me to breath deeply, i did. I delivered him vaginally at 11:54am, but it took the doctor telling the nurse 3 times to bring him the Correct pair of Forceps until the last moment, my husband said the doctor walked over to the table and grabbed the correct pair of forceps and pulled Landon out. Landon's right ear was BLACK, when i asked the doctor why he said 'don't worry, it doesn't hurt him', also when the doctor first got him out he said "the cord was wrapped around his neck" i asked him "is he going to be ok" and the doctor replied "i think we got him out in time", i never questioned him or anything, stupidly. We took landon home, and at first everything was ok, but before landon turned a year old we noticed that he wasn't doing the things his older brother & sisters had done by their milestones. My husband tried to tell me he thought something was wrong, i didn't want to hear it. Needless to say, we took landon to U of M last June to have him evaluated and he was diagnosed as Autistic. He is almost five and only drinks from a bottle still, sometimes he will take a sip from a cup, will only eat baby food, will choke if we try and feed him anything other than babyfood, and is not potty trained, however, he has been attending a Special Needs Preschool and is now making strides and is on the path to being potty trained. This coming friday we have an appt at U of M again to have him sedated and are getting an MRI done to see if he sustained any brain damage at birth. I feel stupid for not ever realizing it, i just didn't want to accept that something could be wrong, we love him more than anything, he is the light of our lives and we all move heaven and earth to make sure he is a happy boy, i just hope if the doctor is responsible we can hold him liable because landon is going to need treatment and therapy and U of M told us last year he will most likely always have to live with us. I hope we can get some information out of the MRI and it will lead us down the correct path for what we need to do for Landon.

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Keep it civil, people.