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Wlodek Lopaczynski, MD, PhD
National Institutes of Health, Bethesda, Maryland, USA
Abstract
Recently, scientific literature informed that metabolic conditions in pregnant women may be associated with increased risk
for autism and other neurodevelopmental disorders in their offspring. In a cohort study of more than 1000 children between
the ages of 2 and 5 years, those who had mothers classified as having "metabolic conditions" (which included diabetes,
hypertension, and obesity) during pregnancy were at a significantly higher risk for developing an autism spectrum disorder
(ASD) and neurodevelopmental delays. In addition, mothers with obesity were 1.6 times more likely to have a child with ASD
and more than twice as likely to have a child with other developmental problems. In the United States, the prevalence of
obesity among women of childbearing age is 34%. Moreover, with obesity rates rising steadily, these results appear to raise
serious public health implications. The main objective of this Editorial is to propagate the health care improvement based on
the translation research approach from basic behavioral sciences and relevant integrative neuroscience to pressing clinical
issues that include an understanding of the etiology and assessment of disorders, and the assessment of functioning and development of innovative and culturally appropriate preventive treatment. Behavioral interventions for weight management
in pregnancy may include the Transtheoretical Model (TTM) employed in obese pregnant women and then, the comparison
with elements of the ecological model. A comparative effectiveness design is to test the effect of tailoring while including one
of the most important predictors of screening-physician recommendation: after careful selection of analyzed behaviors from
the TTM approach. However, there is also a risk that the evidence may not be conclusive for sustained weigh loss as a primary
outcome of the proposed intervention, although the TTM in combination of physical activity and diet tended to produce significant results. Therefore, physicians might use the TTM to convince pregnant women to regulate weight and educate future
parents on how to deal with autism at an early age of their children using watchful waiting management.
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and relevant integrative neuroscience research by pressing issues regarding some aspects of clinical disorders,
including: an understanding of the etiology and assessment of disorders; the assessment of functioning; the
development of innovative and culturally appropriate
preventive treatment and rehabilitation interventions;
and improvement of methods for the effective delivery
of public health services. I also intended to encourage
behavioral scientists to seek further understanding of
behavioral processes through an exploration of how those
processes are altered by mental and behavioral disorders
to transcend the barriers of disciplines in research and
institution settings in order to harness the full range of
modern behavioral sciences to service of the critical
health needs. For this purpose, I will summarize briefly
some recent studies related to this topic.
Historically, improving the dietary health of nations
that are fighting obesity has been a long-standing goal
*This article was prepared by Dr. Lopaczynski in his personal capacity. The opinions expressed in this article are the author's own and do
not reflect the view of the National Institutes of Health, the Department of Health and Human Services, or the United States government.
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REFERENCES
1. Stotland N.E.: Obesity and pregnancy. BMJ 2008; 337: a2450.
2. Krakowiak P., Walker C.K., Bremer A.A., Baker A.S., Ozonoff
S., Hansen R.L., Hertz-Picciotto I.: Maternal metabolic
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