I received a wonderful comment about the hypothesis that early umbilical cord clamping might contribute to the risk of origin of autism from a wonderful former colleague, Dr. David Blake, a researcher in the Department of Neurology at the Medical College of Georgia. His observations:
Fraternal twins typically have different placentas, whereas identical twins share a placenta but have different cords. The blood supply, and pre-clamping susceptibility to anoxia, would surely be different.
There are plenty of reviews associating prenatal or perinatal anoxia with autism already (as well as advanced maternal and/or paternal age). Given that early cord clamping clearly impacts perinatal anoxia, and has been recommended against, it would seem prudent to just change practice and see where that leads in a few years. The evidence that would lead one to think that early cord clamping is a bad idea is elaborate and complex (and amazingly compelling with respect to autism), but changing practice, immediately, is not.
As for the idea that one could statistically detect whether cord clamping is the problem, we can! Amish people do not clamp the cord until placental delivery, and they have no autism rate. The same is true in Somalia, but Somalian immigrants to westernized medical countries have high rates. Try to systematically find out autism rates and immediate cord clamping rates, on a country by country, or region by region basis. It is a task someone should get on immediately, but it will take a lot of effort.
An interesting discussion of the “Amish anomaly” re autism incidence has been provided by Dan Olmsted, who went to Amish Country to find the 150 or so individuals there who could be expected to be severely autistic. They aren’t there. He seems pre-disposed to believe that the difference lies with their non-vaccination. Many studies now show that this is unlikely. As David Blake points out, there is another difference in this population: In Amish birthing, by tradition, the cord is not clamped prior to placenta delivery.
The picture with autism in Somali children is a little murkier. It turns out that the incidence of autism is very high in children of Somali origin who were born in the US (several times higher than normal), while it appears to be very low in Somali children born in their native country. Again, vaccination has been identified as the likely cause by Somali parents and by many observers — but again, clamping follows placental delivery in Somalia, while the cord has been clamped without delay as a general practice in Minnesota, where a high incidence of autism in these children of Somali immigrants was first discovered.
I agree with David. These observations strengthen the arguments that early cord clamping could be a contributing cause of higher AD incidence. We should get our act together and determine, ASAP, the facts of the matter.
Perhaps this IS just another case of outwitting ourselves, as we attempt to outwit that clever old woman, Mother Nature. For the sake of all of the havoc that just might be attributed to this factor, let’s not let another year go by without having these answers.
An afterword: In reading a Huffington Post discussion of the “Minnesota Somali Autism” issues written by David Kirby, it was a sad thing to read the responses of a Somali woman whose family had suffered from this “American disease”. “Some autism families have returned to Somalia (because) they were angry and disgusted with the United States. The nation that offered them refuge was the same nation that made their children so sick. They think that, by returning home, maybe they can make their children better.” To view Somalia as a place in the world where children can escape from a great American miasma seems to this observer to be a rather surprising state of affairs!
