Atropine Sulfate

While research has suggested that the prevalence of autism spectrum disorders in American children was about 1 of every 150 children, a new government study estimates that the prevalence is more likely about 1 in every 91 children.

The study, which is published in the October issue of Pediatrics, estimated that 110 of every 10,000 U.S. youngsters will be diagnosed at some point in their lives with an autism spectrum disorder. That currently translates to about 673,000 American children with some form of autism, according to the study.

“I think this is a very important study that says the prevalence of autism spectrum disorders may be even higher than we suspected previously,” said Geraldine Dawson, chief scientific officer of Autism Speaks.

“Autism is a major public health challenge, and this study is another call to action that we need to be able to provide care across the lifespan,” she said.

Autism spectrum disorders are a group of neurodevelopmental disorders, including autism, Asperger syndrome and pervasive developmental disorder. Severity varies from child to child.

Characteristic behavior includes impaired social interaction, difficulty with communication and repetitive behaviors. Over a lifetime, health-care costs for someone with autism are estimated to be more than $1.6 million, according to the study.

The researchers culled data for the study from the 2007 National Survey of Children’s Health, which included more than 78,000 children from across the country, all between 3 and 17 years old.

Parents of 1,412 children reported that a doctor had given their child a diagnosis of autism spectrum disorder. Only 913 parents, however, said their child currently had an autism spectrum disorder.

Of that group, 494 parents classified their child’s autism as mild, and 320 parents described it as moderate. Just 90 parents said their child’s autism was severe.

Cynthia Johnson, director of the Autism Center at Children’s Hospital of Pittsburgh, part of the University of Pittsburgh Medical Center, attributed the increase to better diagnostic criteria and an increasing awareness of autism.

“This is more data that adds to what’s already in existence that shows autism spectrum disorders are common,” Johnson said.

As to the large percentage of children who were diagnosed with an autism spectrum disorder in the past, but whose parents said they currently were not autistic, Johnson said the reasons behind that finding were not clear.

She theorized, though, that “symptoms may lessen with early intensive services, especially for milder cases.”

The authors also suggested that autism might have been considered during the initial diagnosis of a child but later dropped if the child turned out to have another disorder.

“We do know that individuals with autism can have a diagnosis early on and then lose that diagnosis, and we don’t know the factors that could explain this,” Dawson said. “Is it having received good, early behavioral intervention? Or, is there a group of kids that have better biological outcomes? Or, it may have something to do with how kids get diagnosed at different ages. Maybe as kids develop, they may not be getting the same kind of evaluations.”

The study also found that the odds of receiving an autism spectrum disorder diagnosis were four times higher for boys than girls, and that non-Hispanic black and multiracial children were less likely to have an autism spectrum disorder than white children.

An estimated 13 million infants worldwide are born premature each year and more than one million of them die within the first month of life, according to a report released Sunday.

Premature births account for 9.6 percent of total births and for 28 percent of newborn deaths, the data in a White Paper from the March of Dimes and other organizations found.

The highest rates of premature birth are in Africa, followed by North America (Canada and the United States combined).

“Premature births are an enormous global problem that is exacting a huge toll emotionally, physically and financially on families, medical systems and economies,” Dr. Jennifer L. Howse, March of Dimes president, said in a news release.

In the United States alone, the annual cost of caring for preterm babies and their associated health problems is more than $26 billion a year.

“If world leaders are serious about reaching the United Nation’s Millennium Development Goals to reduce child mortality and improve maternal health, then strategies and funding for reducing death and disability related to preterm birth must receive priority,” Howse said.

The March of Dimes’ Global and Regional Toll of Preterm Birth report used data from the recently published Bulletin of the World Health Organization, which probably underestimates the extent of preterm birth worldwide, according to Howse.

More than 85 percent of the world’s preterm births occur in Africa, where about 11.9 percent (four million babies a year) are born preterm. Rates in other regions are: 10.6 percent in North America; 9.1 percent in Asia; 8.1 percent in Latin America and the Caribbean; 6.4 percent in Oceania (Australia and New Zealand); and 6.2 percent in Europe.

In more affluent regions, 1,014,000 infants each year are born preterm — 7.5 percent of total births. In middle-resource regions, 7,685,000 infants are born preterm — 8.8 percent of total births. In low-resource regions, 4,171,000 infants are born preterm — 12.5 percent of total births, according to the report.

Rates of preterm birth in the United States have increased 36 percent in the past 25 years due to a number of key factors. More women over age 35 are getting pregnant and there’s increased use of assisted reproductive technologies, resulting in more multiple births, the report stated.

Infants who survive preterm birth are at risk for a number of serious lifelong health problems such as cerebral palsy, blindness, hearing loss, and learning disabilities.

Currently, there is no reliable way to prevent or delay preterm birth.

“While much can be done right now to reduce death and disability from preterm birth even in low-resource settings, we need to know more about the underlying causes of premature birth in order to develop effective prevention strategies,” Christopher P. Howson, vice president for global programs at the March of Dimes, said in the news release.

The authors of the new report said more needs to be done to educate health professionals, policy makers, women of childbearing age, and others about the global toll of preterm birth, as well as how to care for women with high-risk pregnancies and their babies.

The report is scheduled to be presented this month at the International Conference on Birth Defects and Disabilities in the Developing World, held in New Delhi, India.