I just finished reading a very interesting article in the most recent Cure Autism Now "Advances" newletter. It was written by a Pediatric Neurologist at the Kennedy Krieger Institute by the name of Andrew Zimmerman.
He talked about a study he conducted that seems to suggest a link between the drug terbutaline and autism. Terbutaline is generally used for individuals with asthma, but can also be used to arrest premature labor during pregnancy. I was one of those individuals who experienced premature labor at 24 weeks with my twins and was put on 24/7 bedrest until delivery. I took terbutaline around the clock to keep my contractions at bay. The thought is that the terbutaline causes changes in a certain receptor in the fetus brain that prevents it from "down-regulating" normally after birth and during the child's development. This is the first I've ever heard of the possibility of this drug having ties to autism.
What's interesting to note is that my fraternal twins are boy/girl. My son is the one diagnosed with ASD, my daughter is NT. The article noted that there appears to be a specific genetic susceptibility to the effects of terbutaline.
I'm just curious if there is anyone out there who frequents this board who also took this drug during pregnancy? In my case, it's difficult to determine whether or not I'd have taken the drug if I'd known there was a potential for autism (the article indicated this is still in the research phase). What's a greater risk......having two babies born at 24 weeks (and therefore possibly not surviving), or the slight possibility of having one or both born with autism? Tough call.
I took Breathine with 2 of my pregnancies, one with nothing, and the last with terb.
I was on Breathine for 3 months with my oldest -- he's nt. I was on Breathine for 3 weeks with ds #2, he has many things - ASD is one. Nothing with #3 and she has some sensory and speech/language issues. I was on terb. for 5 weeks with last dd. She has some slight speech and motor skill issues.
Michelle
With my first two I took it, and out of the two the middle one has ASD. My oldest is NT and really has no problems at all.I took Terbutiline in my 3rd pregnancy after I went into labor at 31 wks and dialated to 3 cm. I don't remember how long I took it...I was in the hospital for a 5 days and then bed rest until 37 wks. We are still not sure if Gabe has PDD...he is definately emotionally and developmentally delayed as well as Speech Delayed. Even at age 7 and 3 yrs speech OT he is still difficult to understand if you are an outsider. For now we treat him with Strattera for the ADHD aspect which has helped him to settle down. He has a lot of food adversions as well and is really underweight but for now the Dr.'s say just let him eat what he wants to eat. Sadly he has had NO adversion to anything junk food. lol His Psych. said that she would like to reassess the possibility of PDD in a year or two. He is in Special Ed. under the OHI (Otherwise Health impaired) label.
My son Jesse is our definate Aspergers child and at age 2 he was diagnosed as Autistic. He continued progressing and because so little was and still is really understood about the disorder the schools didn't want to label him. He was severely speech and language impaired and has always been developmentally and emotionally delayed. He is 10 now but is more like a 7-8 yr old in emotional development. Its hard because he is a very tall child and so many expect more because he "looks" normal. I had absolutely no preterm labor with him and no drugs...he was the most event free pregnancy out of all my pregnancies.
Yes, I was given Trebutaline multiple times with my son.
Just another thing to make us think we could have had something to do with with this.I did not have it with any of my pregnancies. But, I did have a Rhogam shot - with all of them but I had flu shot with dd, and not ds! I did have antibiotics a few times with ds due to a UTI. Did have an epidural, but also some other drug before that - can't remember the name. They couldn't get the epidural to me for a while, so they gave me the other first. Did not have that with dd, but did have epidural. Was head-butted in abdomen at 25 weeks, had a few contractions which resolved on their own, otherwise - very normal pregnancy. Ooops! Except for borderline high-blood pressure and severe water retention the last 7 weeks of my pregnancy. I probably had undiagnosed gestational diabetes with ds. I definitely had it with dd. Both kids were over 10 pounds. They changed the guidelines between my pregnancies, so I probably would have been considered having gestational diabetes with ds as well...More than welcome to use my post, particularly since I initially posed the
question.
I too thought about contacting Dr. Zimmerman to dwelve further into this.
Please let me know if he calls you back. I would be happy to participate in
any type of research study.
Shelly Go ahead and use my post too! If there is a connection, I'd sure like to know.I took it with both of my boys DS1 is NT and DS2 has an ASD. I wish I had known.
O.K. Did a bit of a yahoo search on this and uncovered some more interesting information.
Apparently, terbutaline isn't even approved by the FDA for use in pre-term labor. It's used as an off-label drug by doctors. They have warned doctors that it is potentially dangerous and might not be effective. However, in 2002 at least 63% of all prescriptions for terbutaline were for pregnant women. It's also generally prescribed at much higher dosages than the recommended dosage for asthmatics. This is according to Dr. Kaplan from John Hopkins University.
They really need to do more research on this drug. The more I read about it, the more alarmed I am.
Shelly
Lachlan was born prematurely at 29 weeks, but I did not go into labour. My placenta had calcified and I developed pre eclampsia.
I was given 2 steriod shots, however 1 of those was thought not to have had enough chance to work.
Full term pregnancy with Nicholas.
I read a study that indicated women who had dental problems during pregnancy were more likely to give birth prematurely - I wonder how many of us fit into that category? I had a double abcess and refused any painkillers for it.
I have always thought the prematurity was Lachlans main cause of ASD.
Mysh
I just discovered you can go to the FDA website and submit an online report outlining any suspected problems related to product/drug use. The report can be located at:
https://www.accessdata.fda.gov/scripts/medwatch/
Think I'm going to fill it out and send it in. Maybe if they hear from enough individuals it might prompt them to conduct some additional research on the use of this product for pre-term labor.
Even if in the end we might have all decided to use this drug to stop our preterm labor I believe we had a right to be told that it could possibly cause fetal problems. Years ago they used to give women yutapar (sp) to stop preterm labor until it was discovered that it caused infant apnea and other breathing problems. We should have been warned... I love my son but I worry constantly about his future. How different life might be if we didn't live in the shadow of autism.
I totally agree we should have been told of the risks. Whatever happened to informed consent????
At least by knowing of the risks, I may have identified my son's autism earlier and been able to start the intervention process at a younger age (rather than at 3.5).
I was talking with a neighbor last night about this issue and she indicated she used to work for the FDA. She stated they NEED TO BE TOLD about this. I suspect they have some inkling as to how this drug is being used, but for whatever reason haven't taken any steps to control it. And quite frankly I'm not quite sure how one goes about getting the FDA involved. However, I think this might just be the tip of the iceberg as far as this drug is concerned.
Would I have taken it if I'd known of the risks.....hard to say. If it's truly the only option currently out there, probably. but at least I would have known what to look for. Instead, I feel a bit like an experiment gone wrong.
Shelly
Well I wouldn't have used it if I'd known there was risks, because I was 34 weeks when I went into labour, and they knew she was a good weight and in a good position. They just said it was policy to try and stop labour if it's before 36 weeks. No.
I took it for all of my pregnancies - weird seeing how DH and I were talking about that this morning = hmmm.....because I am 4.5 months PG now and I haven't had to take anything but we fear pre-term labor as I have always had it with the others.
I had pre-term labor with my 1st was magnesium in teh hospital he was born at 32 weeks I also had 2 rounds of steriod shots to mature his lungs because I was dilated to 4 at 30 weeks.
I had no pre-term with my dd she was born at 38 week
I had pre-term labor with my son I took something don't remember what it was he was born at 36 weeks, I think it was a blood pressure med which I also took every 4 hrs to keep uterus quiet I also had a round of steriod shots as well
I did have pre-term with my last son and had something and didn't work so I was again given magnesium . He was born at 36 weeks
I am almost 27 weeks now so we are hopeful that it will be like my daughter I was given a drug to stop prem labour with Sharlet, don't know the name.
DW took something to stop pre-term labor with the twins - at about 33-34 weeks, iirc. But, she also got a Rhogam shot, had the kids vaccinated, and let them watch baby eintein, so who knows. I went into preterm labor with Eric at 32 weeks gestation, was given Terbutaline by IM injection for 3 days, then by mouth for about a 5 weeks after that. But, I also remember having dental work before I conceived Eric, replaced old fillings (amalgam) and had a crown done, and about a month or two before conception I had an odd viral infection which had no symptoms other than a high fever for 7 days during which I lost almost 10 pounds and went down to my high school weight. During Eric's birth (he was a double footling breech) the doctor had a difficult time getting him out of my pelvic area - his feet were stuck - and Eric was not breathing and a little blue by the time they extracted him by C-section. So, any or all these factors could have been the cause for Eric's condition. I never took it with any of my pregnancies. Don't have asthma and never (knock on wood) have went into preterm labor. (pregnant now so knocking on wood) Karrie I got it like sugar pills! Especially when I was pregnant with Fabian and he is my most low functioning of the children. I am currently writing a letter to my neuro about it to see about the possibility of a research study partnership or something with Dr. Zimmerman and I have even contacted Dr. Zimmerman's office and am awaiting a call back. I am so scared now because I am prone to preterm labor and I cannot tolerate the Magnesium! Ugh!!!! Quick question - As I am writing the letter to my neuro - I am requesting authorization to use your posts as back-up to my concerns. I did not want to print it out and attach it without your consent. Thanks!!! Wow, more of you responded with a yes than I anticipated. For those of you who are interested in reading the article it can be located at: look under the "newsroom" link, Publications, Fall 2006 or try: http://www.cureautismnow.org/atf/cf/{0FE985F1-B3E3-476B-92EF -73240E60AF4D}/ADVANCES_FALL2006.PDF I really hope they do more research on this drug. I believe it's prescribed pretty freely, and I HIGHLY doubt most OBGYN's have any clue there's a possible link. At a minimum, if it's determined terbutaline can contribute to autism, parents should be made aware of this so they can make a well informed decision regarding it's use. ---------------------------------- DS 5/HFA, DD 5/NT Hi, Krystal. Yes, go ahead and use my post if you like. You are free to use mine...I got to thinking more about it today. I know they did the Terbutiline and magnesium both at the hospital because they were really aggressive in trying to keep me from dialating any further. When they sent me home on bedrest they put me on a Blood pressure med also along with Tylenol #3 that I took together every 4 hours around the clock to keep my uterus under control. I also wondered about the use of steriods as a possible cause of my son Gabe's delays. I not only got it in the hospital but for 3 wks after discharge I got 2 shots a week. Again he hasn't been diagnosed yet with PDD but he has many of the qualities. When I got to that same time as my daughter (31wks) a new OB went ahead and did one round of steriods just to be sure. I asked if I should have had more and he said no because having several rounds of the drug doesn't neccessarily speed up the development that much faster. I am glad I got in the one round, but she was still 6 wks early and had to be in the NICU for 10 days. I wonder if she would have had more difficulties if he had neglected to do the steriods at all. I had the magnesium, the steroid shots, and the antibiotics to stop my preterm labor. I have twin boys, fraternal, one is HFA and the other is NT. I have always attributed his autism to his rough start in life (he couldn't even regulate his own temperature the first day.) He was much smaller than his brother, even at almost full-term, but a little fighter and survivor. I've been lurking on this site for a while and finally had to register when I saw this question. After 6 years of looking for answers and getting dx of AS (w or w/out ADHD/mood disorder depending on who you talk to) I had to reply. I "discovered" AS in researching what could be wrong with my son and my final straw, piece of the puzzle. was the numerous articles/research which appeared when I googled terbutaline. With my twin pregnancy I was started on magnesium sulfate, oral brethine(sp?), and was finally given a transfusion pump (diabetics use these) which gave me increments of the drug all day and when I had too many contractions, I would bolus myself with extra doses to keep contractions at bay. Did this for month/month-and-a-half. The only other mother I've ever met who had the transfusion pump of terbutaline had twin boys who were both born autistic. I believe I should have been told of this drug's off-label use. However, would I have taken the risk of losing one or both babies or been told having a - say __% risk of having a child with special needs? I still probably would have taken the med. Well from what I've read the FDA already knows there is no conclusive evidence showing that Terbutaline effectively stops labor. In fact, I believe I read that in 1997 they recommended doctors stop using it for the treatment of pre-term labor. That said, my sister was just given Terbutaline in September to stop her labor so apparently no one is listening. I spoke with my ob/gyn about this and her reply was that technically pre-natal vitamins are used "off label". With so much hype over Thimersol in vaccines and autism, I think a lot of professionals may just roll their eyes on any new theories. Yet, when my twins got their MMR vaccines, they immediately got 106 degree fevers and had red dots all over. When I called to say I thought they had the measles, the doctor's office repeatedly assured me that a reaction to the vaccine takes two weeks and I was wrong. After 1/2 day with no drop in temp I took them in to be told they had the measles. No Duh
Copyright Autism-PDD.net