Sunday, May 20, 2012

Ultrasound and Autism - a possible link?


Could the increased use of ultrasound during pregnancy be implicated in autism?

That’s a question I discussed yesterday with University of Louisville researcher Manny Casanova.

A few stories have raised this question in recent years, but none have elaborated on the possible process, as he did for me yesterday.   Here’s what he said:

Ultrasonic energy is known to affect cellular membranes and cell growth.  In fact, ultrasound is used as a therapy to accelerate bone growth following certain traumatic injuries.  In stem cell research, ultrasound has been shown to accelerate development of cells.  Knowing that stems cells are developing into neurons early in the fetal development, it’s quite possible that addition of ultrasound energy might shift that balance.  

Those were questions that I’d not heard before, when it came to ultrasound.  

When I got back to my hotel room, I discovered a number of scientific papers supporting each of his points, but none really put the ideas together in the context of autism. I found that fascinating, and somewhat disturbing.

What I had heard were these questions:

Heating and vibration might also affect a fetus.  Ultrasound will heat water, and the operation of ultrasonic cleaning systems is familiar to many of us.  Either of those processes might affect fetal development adversely too.

Like many people, I took for granted the idea that whomever approved ultrasound for clinical use made sure the power levels were low enough that the developing baby wasn’t cooked by its operation, or disintegrated like dirt on jewelry in the cleaning tank.

Not so fast, Manny cautioned me . . .

When ultrasound was developed, it was first used late in pregnancy, when all these risk factors are minimized.  It was also used by trained staff and the machines, being new, were likely well calibrated.  Most moms did not get ultrasound at all, and those who did typically received one or two.

The situation today is totally different.  Many doctors do ultrasound much earlier in an effort to spot other problems, like Down’s syndrome.  It’s common for moms to get three, four, or more ultrasounds done.  Finally and most disturbing, many states have “ultrasound boutiques” in malls where moms can get ultrasounds as art; for the new baby scrapbook. 

When the goal is a pretty picture, power levels may be turned up unwittingly.  Safety is assumed by operators who are not always medical people, and who may have little knowledge of the underlying processes.

So we have the confluence of more ultrasounds, done earlier, and possibly with poorly calibrated equipment and inadequately trained people.  I always associated ultrasound with professional staff in a hospital, but to hear Manny, it can be a lot more like a tattoo parlor experience. 

In fact, several states have no regulation at all over the use of ultrasound imaging equipment.  Anyone can buy it and make pretty pictures of your innards, perhaps cooking or altering you in the process.  In the hands of the wrong operator, it's like taking your developing baby and stepping into the microwave oven.  That's something none of you would do, yet the mall ultrasound parlors reportedly do a brisk business.  

Ultrasound Zeke has a wall full of beautiful fetal art, but it may have come at a high cost.  

I hesitate to say that’s a frightening prospect, but it’s certainly one I’d study more carefully.  If I were pregnant today, I’d be thinking hard if my doctor advised ultrasound early on, and I’d be reluctant to do it very often.

An energy process that makes broken femurs heal faster is not the sort of thing you want to fire into the brain of a developing fetus.  His brain is developing fast enough, all on its own.  We don’t need to amp up the rate of neuron development.

Remember . . . outside of evolution and the natural appearance of autistic people throughout history, we may never find a single pathway into autism.  There may be a hundred other causative factors.  I'm not suggesting this is THE CAUSE and neither is Manny.  This may or may not be involved . . . I simply suggest it's worth exploring further.

This is the second interesting question from IMFAR 2012.  What are your thoughts?

John Elder Robison
Writing from IMFAR 2012
Toronto, Ontario, Canada

17 comments:

Elise said...

This is very interesting. When I was pregnant with my oldest, since I had a history of miscarriage, and started to spot, the dr ordered an ultrasound at 3 months to make certain the baby attached to the uterus wall properly. But he refused to allow an ultrasound during the rest of the pregnancy becasue they were not certain what kinds of effect ultrasound has on the developing baby. With my younger son I had an ultrasound during the amnio. That was 20 years ago.

But what about those who were born before the advent of this technology?

laughing helps said...

i'm not sure about the autism, but doubt it has much to do with aspergers - personally i had to have ultrasounds done with all three of my kids - none were born with aspergers - on the other hand, my husband and his dad both have aspergers and neither's mother had ultrasounds....

MG Atwood said...

I have had feelings that in years to come, they would find that all of the ultrasounding done during pregnancies were going to be harmful. Young women today are have three and four routine ultrasounds. Sadly, some of these are my grandchildren, and we will have to wait to see the outcome.

oldflamingo said...

I'm 63, and an RN (retired) who has worked in family planning and prenatal care for over 30 years . The women in my cohort had no autistic children. So I have thought often about what is different with prenatal care, prenatal life, from 40 years ago. The two things I came up with were ultrasounds, and the use of microwave ovens--both capable of scrambling developing neurons and synapses. I think ultrasound is grossly overused, usually unnecessary, and most moms think its only to determine the gender of the baby. Sad. Thank you for this article.

Niksmom said...
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Niksmom said...

I will be very curious to follow any research in this area. I had a high-risk pregnancy with many ultrasounds beginning as early as 12 weeks. Nik was born at 27 weeks and spent nearly 7 months in the NICU. During that time, he had very frequent cranial ultrasounds to follow his brain development. He has multiple neurological/developmental issues including autism.

forsythia said...

More research is needed. I know of a chld with a mild case of Aspergers. The little girl's mother was plagued by fears of fetal abnormality during pregnancy. She had a nearly unmanageable case of OCD and and had ultrasound after ultrasound until one of the doctors called a halt.

Zazou said...

Very interesting, John.
We hadn't heard this before, but the factors you mention certainly make sense. We attended a seminar this year in which the accelerated brain growth of children on the spectrum was mentioned. Research is ongoing, but the findings so far indicate that the brain grows faster for children on the spectrum. Why would this be so? The ultrasounds may be a clue. Looking at our own case, my husband has Asperger's, and there were no ultrasounds during his gestation. However, I had two for our son, both considered necessary because I miscarried his twin. Could this have amplified the genetic tendency? More research needs to be done. We're sorry we missed you in Toronto. Hope to see you someday. Have a great week.

Me said...
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Thorny said...

Wow, this is... it's very interesting. I am a mother of autistic twins, and one thing that I've learned is that autism is somewhat more common in twins than in singletons.

Know what else is more common with twins than with singletons? Ultrasounds.

When it was discovered I was pregnant with twins, my pregnancy went from "normal" to "high-risk" as far as my OB was concerned. When periodic ultrasounds revealed a placental abnormality (Twin-to-Twin Transfusion Syndrome), suddenly I was getting ultrasounds every two weeks. And then, in the last 4-6 weeks of my pregnancy, they did fetal monitoring tests twice a week, and if they couldn't get a solid strip of tape on either twin, they would send me down to have an ultrasound done. It was never as long as the regular ones, but still - I honestly lost track of how many ultrasounds I went through during my pregnancy. At least half a dozen, and probably more.

I will be interested to learn more about this research, as it continues.

Carol Filar-Prescott said...

This is interesting and hope it can be researched further.
And, it is unfortunate that the ads below the comments are all for do-it-yourself ultrasound equipment. (at least that's what turns up on my screen)

Evan said...

Here in Australia, I think using ultrasound equipment is more regulated. The obstetrician has a low powered version, and if you need better resolution (higher powered) you visit a radiologist (same people who do CT scans and X-rays.)

The thought of "ultrasound boutiques" struck me as... well the first word that came to mine was "vulgar".

Going off my experiences with three pregnancies, the obs will only prescribe the minimum necessary, and certainly seem reluctant to do extras arbitrarily.

For a perfectly normal pregnancy (such as our first) you have only one ultrasound around 18-20 weeks. This is the standard "make sure things are developing properly and we'll check out the sex while we're here" scan.

We had an additional scan at 12 weeks during our third pregnancy just to make sure everything was coming along fine because we had a miscarriage (the second pregnancy.)

(Coincidentally(?) our second child is mildly aspie while our first is NT. I doubt the extra ultrasound was the deciding factor though - while I don't qualify as ASD I score closer than the average NT (and my wife is not far behind me.)) :-)

Obviously, for higher risk pregnancies more ultrasounds are prescribed.

janie1234 said...

I find this extremely interesting due to the fact that my 10 year old is currently being evaluated for aspersers. I have 4 children but Gavin has always been unique. He is gifted and has ADHD but I knew that was not "all" something else was missing. He prefers to be alone, he does not make eye contact, he has routines and he "knows" he is different from other kids. The reason I am writing this is because he was a high risk pregnancy. I had numerous ultrasounds with him because I had bleeding through my entire pregnancy. Then I developed gestational diabetes and that lead to more ultrasounds. He was delivered early at 37 weeks due to inner uterine growth restriction. He was 5 pounds 3 oz when he was born. Your link makes me wonder and want to research more!

Peg said...

I've had two children, born in 81 and 83. With both my boys, the Dr. wanted to do ultrasounds, and I refused them. I asked if there were some medical reason for wanting them, and he said no, but it was just a way to check more closely on the fetus. I told him that I didn't want to find out 30 years down the road that there were problems with having had them. He was frustrated, but I had my way. My boys are fine, but there is no way I would have been convinced that ultrasound was responsible, if something had happened. And now this article...I'm glad I stood my ground.

ppppparker said...

This is very interesting... I have never though of an ultrasound as being something dangerous. I will definitely have to look into it some more and talk to my doctor to see what she thinks.

lynne morgan said...

my second, highly aspie child, had ultrasound at 12 weeks. The foetus was jumping around like a hyperactive shrimp. After that I refused ultrasound scans whilst pregnant and any form of medical intervention and immunisation.

Sondra Dangler said...

I thought I heard recently that the incidence of Autism has increased so significantly in the past 30 years. I have given a lot of thought to this recently. I think because so far I have been blessed with 7 Grand-children and 3 Great-Grandchildren and so far all seem healthy. But I wondered just what has gone on in the past say 30 years that did not go on before that. The pregnant woman still gets vitamins and is watched probably more closely than ever. How ever there is one thing that happens to all pregnant woman today and has pretty routinely since the late 80’s. The Ultrasound. I had 5 pregnancies and in those 5 pregnancies I NEVER had an Ultra sound. I cannot but wonder if when you send those sound waves into the brain of a developing fetus if it does some kind of damage. I would think it would be no different than if you were building a tower of cards and sent a flow of air in to the middle of the tower. If a cell is going to grow or split and gets bombarded with a sound wave couldn’t it disrupt the way the cell reacts? If this thought has already been tested I would appreciate receiving information on the results. If you know of no study, is there someone I could write to or maybe you could send me an address of a researcher that might look into this. Please let me know as if there is nothing you can do I can keep looking for someone to help me on this.
Thank you for your time in this matter. ‘

Sondra Dangler
P.O. Box 1057
Donna Texas 78537