Fetal and Infancy Growth Pattern, Cord and Early Childhood Plasma Leptin, and Development of Autism Spectrum Disorder in the Boston Birth Cohort.
Very rapid infant weight gain plus high leptin at age two sharply raised later autism odds in this cohort.
01Research in Context
What this study did
Doctors tracked Boston babies from birth to preschool. They weighed each child often and froze a spot of cord blood. At about age two they took another blood sample and checked leptin, a hormone that tells us when we are full.
Years later they looked at who got an autism diagnosis. They asked: did very fast weight gain or high leptin predict ASD?
What they found
Babies who zoomed up the weight chart and also had high leptin at two years faced three to eight times higher odds of later autism. The two signals worked on their own, but leptin explained part of the weight–ASD link.
How this fits with other research
Li et al. (2016) pooled five studies and saw the same direction: heavier moms mean slightly more autism in kids. Ramkripa’s team moves the spotlight from mom’s fat to baby’s rapid gain and adds a blood marker.
McConkey et al. (2010) found the opposite weight story—low birth weight raised ASD odds. The two papers look contradictory, but they measure different windows. R studied pounds at birth; Ramkripa studied speed of gain after birth. Both say weight pathways matter, just at unlike times.
Chezan et al. (2019) and Smit et al. (2019) widen the lens. They link mom’s pre-pregnancy BMI and pregnancy weight gain to later autism or autism-like traits. Together the papers build one theme: early-life adiposity signals, whether in mom or baby, forecast neurodevelopment.
Why it matters
You can’t change genes, but you can chart weight. Flag babies who cross two centile lines before their first birthday. Share the curve with the pediatrician and, when possible, request a leptin draw at the two-year visit. Early extra pounds plus high leptin won’t diagnose autism, yet they tell you which families need closer developmental watch and perhaps feeding guidance.
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02At a glance
03Original abstract
Leptin is a proinflammatory cytokine that plays an important role in energy homeostasis. Emerging evidence suggests that leptin levels are altered in children with autism spectrum disorder (ASD); however, this has not been studied prospectively. Rapid growth during infancy and early childhood has been implicated in ASD, but the evidence is inconsistent. As leptin is involved in growth and is a potential risk factor for ASD, we explored the associations between (a) cord, early childhood leptin and ASD; and (b) birth weight for gestational age, early childhood weight gain, and ASD. We also assessed the mediating role of leptin in the relationship between weight gain during infancy and ASD. This study was conducted in a sample of 822 subjects from the Boston Birth Cohort. ASD was defined from diagnostic codes in electronic medical records. Extremely rapid weight gain during infancy was associated with a greater ASD risk and this persisted after adjusting for potential confounders (aOR: 3.11; 95% CI: 1.37, 7.07). Similarly, children that had higher plasma leptin levels, prior to ASD diagnosis, had an increased ASD risk in both unadjusted and adjusted models (aOR: 7.87; 95% CI: 2.06, 30.04). Further, early childhood leptin indirectly mediated the relationship between rapid weight gain and ASD. No associations were found between birth weight for gestational age, cord leptin and risk of ASD. Our findings provide a basis to further explore whether the combination of early life growth pattern and a biomarker such as leptin can predict ASD earlier. Autism Res 2018, 11: 1416-1431. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Is early life growth and a biomarker leptin related to ASD risk? To answer this question, we followed 822 children from birth and found that those who gained weight very quickly in infancy, had higher leptin levels in early childhood, had a greater chance of later ASD diagnosis. More research is needed to see if infant's weight gain pattern along with a biomarker (such as leptin) can be used to identify children with ASD sooner.
Autism research : official journal of the International Society for Autism Research, 2018 · doi:10.1016/B978-0-12-801311-3.00006-8