Thursday, April 25th, 2013
Pregnant women who use an anti-epilepsy drug called valproate have babies that are 5 times more likely to be diagnosed with an autism spectrum disorder (ASD), according to a new study published in the April 24 issue of the Journal of the American Medical Association. More from CBS News:
“This is an important risk factor and one that can be avoided or at least the risk reduced in women who don’t need to take this and can take another drug,” Dr. Kimford Meador, a professor of neurology at Emory University in Atlanta, said to Businessweek. Meador wrote an accompanying editorial published in the same journal issue. “This is the strongest evidence to date that there is a link between fetal exposure and childhood autism or autism spectrum disorder.”
The Centers for Disease Control and Prevention now estimates that 1 in 50 school age children may have an autism spectrum disorder (ASD). ASDs are a group of developmental brain disorders that affect social, communication and behavioral development. The disorders can range in severity from people with milder symptoms — called Asperger syndrome — to those with autistic disorder or “classic” autism.
Researchers looked at 665,615 babies born in Denmark between 1996 and 2006. The children were followed for an average of 8.8 years. Out of the group, 5,437 were diagnosed with an autism spectrum disorder, and 2,067 were diagnosed with childhood autism specifically.
The researchers found that mothers of 2,644 children took anti-epileptic drugs during pregnancy, with 508 specifically taking valproate. They determined that valproate was linked to an absolute risk of 4.42 percent for an ASD and 2.5 percent for childhood autism.
For women who had epilepsy who did not take valproate, the absolute risk of having a child with an ASD was 2.44 percent, with 1.2 percent receiving a diagnosis of childhood autism.
In January 2013, a British study of 415 children also linked autism to mothers taking valproate. Those results were published in the Journal of Neurology, Neurosurgery & Psychiatry.
“Women for whom valproate is a treatment option should discuss the risks and benefits of this drug with their doctor prior to pregnancy, to ensure that their health and that of the potential child is optimized,” Rebecca Bromley, a clinical psychologist and research associate at the University of Liverpool who led the British study, told HealthDay.
Image: Pregnant woman, via Shutterstock
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Thursday, April 4th, 2013
Doctors are increasingly making the diagnosis of “GERD,” or gastroesophageal reflux disease, in infants, and the label may be prompting parents to medicate for infant issues that pediatricians would otherwise regard as normal, such as crying and spitting up.
A new report published in the journal Pediatrics argues that the use of the disease label is leading to the growing use of medication. “Labeling an otherwise healthy infant as having a “disease” increased parents’ interest in medicating their infant when they were told that medications are ineffective,” the article concludes. “These findings suggest that use of disease labels may promote overtreatment by causing people to believe that ineffective medications are both useful and necessary.”
Previous research has already established the growing number of medical interventions for GERD. One 2010 study by the Food and Drug Administration found that the prescription rate for a particular class of acid blockers increased 11-fold in the years between 2002 and 2009 for babies under age 1.
The new study, which was conducted as a survey of parents in a general pediatric clinic, attributes the rise to the use of the disease label GERD. From the survey’s abstract, “Parents who received a GERD diagnosis were interested in medicating their infant, even when they were told that the medications are likely ineffective. However, parents not given a disease label were interested in medication only when medication effectiveness was not discussed (and hence likely assumed).”
Image: Crying newborn baby, via Shutterstock
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Tuesday, April 2nd, 2013
Over the past decade, diagnoses of attention deficit hyperactivity disorder (ADHD) have grown exponentially, with 11 percent of school age children–and 1 in 5 boys–having a diagnosis. The New York Times reports on the new numbers, which come from research by the Centers for Disease Control and Prevention:
The figures showed that an estimated 6.4 million children ages 4 through 17 had received an A.D.H.D. diagnosis at some point in their lives, a 16 percent increase since 2007 and a 53 percent rise in the past decade. About two-thirds of those with a current diagnosis receive prescriptions for stimulants like Ritalin or Adderall, which can drastically improve the lives of those with A.D.H.D. but can also lead to addiction, anxiety and occasionally psychosis.
“Those are astronomical numbers. I’m floored,” said Dr. William Graf, a pediatric neurologist in New Haven and a professor at the Yale School of Medicine. He added, “Mild symptoms are being diagnosed so readily, which goes well beyond the disorder and beyond the zone of ambiguity to pure enhancement of children who are otherwise healthy.”
And even more teenagers are likely to be prescribed medication in the near future because the American Psychiatric Association plans to change the definition of A.D.H.D. to allow more people to receive the diagnosis and treatment. A.D.H.D. is described by most experts as resulting from abnormal chemical levels in the brain that impair a person’s impulse control and attention skills.
While some doctors and patient advocates have welcomed rising diagnosis rates as evidence that the disorder is being better recognized and accepted, others said the new rates suggest that millions of children may be taking medication merely to calm behavior or to do better in school. Pills that are shared with or sold to classmates — diversion long tolerated in college settings and gaining traction in high-achieving high schools — are particularly dangerous, doctors say, because of their health risks when abused.
Image: ADHD, via Shutterstock
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Thursday, March 21st, 2013
Black children are less likely than kids of other races to receive prescriptions for antibiotics when they visit the doctor, according to a study published this week in the journal Pediatrics. More from the blog The Grio:
The findings are based on 1.3 million doctor visits with the same 222 providers, and were independent of age, gender or type of insurance.
This is not the first time research has shown racial biases among health professionals. A smaller study at the University of Washington, showed that unconscious racial biases affected the amount of pain medication given to black children when they needed it. And a Johns Hopkins study highlighted that primary physicians with unconscious racial biases tended to dominate conversations with black patients, ignore their social needs and exclude them from the decision-making process.
However, today’s study is one of the few to look at its effects on respiratory infections and antibiotic use in children.
“Our goal has always been to find ways to improve antibiotic prescribing for children,” says study author Dr. Jeffrey S. Gerber, who is also assistant professor of pediatrics at the University of Pennsylvania School of Medicine’s Division of Infectious Diseases.
“These analyses [then] revealed the differences in prescribing by race.”
Although, what this study has uncovered may not be a negative. In the age of antibiotic overprescribing and the fear that unnecessary antibiotics later lead to “superbugs” that are too strong to treat, this may in fact be a good thing.
“Overprescribing of antibiotics to children with [respiratory tract infections] is common,” Gerber says.
Image: Child at the doctor, via Shutterstock
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Wednesday, November 21st, 2012
Children who are the youngest in their school classes are more likely to score lower on standardized tests, and to receive medications for attention deficit hyperactivity disorder (ADHD). From The New York Times:
The findings suggest that in a given grade, students born at the end of the calendar year may be at a distinct disadvantage. Those perceived as having academic or behavioral problems may in fact be lagging simply as a result of being forced to compete with classmates almost a full year older than them. For a child as young as 5, a span of one year can account for 20 percent of the child’s age, potentially making him or her appear significantly less mature than older classmates.
The new study found that the lower the grade, the greater the disparity. For children in the fourth grade, the researchers found that those in the youngest third of their class had an 80 to 90 percent increased risk of scoring in the lowest decile on standardized tests. They were also 50 percent more likely than the oldest third of their classmates to be prescribed stimulants for A.D.H.D. The differences diminished somewhat over time, the researchers found, but continued at least through the seventh grade.
The new study, published in the journal Pediatrics, used data from Iceland, where health and academic measures are tracked nationally and stimulant prescription rates are high and on par with rates in the United States. Previous studies carried out there and in other countries have shown similar patterns, even among college students.
Image: Girl with prescription drugs, via Shutterstock
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