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Trophoblast Inclusions Are Significantly Increased
in the Placentas of Children in Families at Risk for Autism

Cheryl K. Walker, Kaitlin W. Anderson, Kristin M. Milano, Saier Ye, Daniel J. Tancredi,
Isaac N. Pessah, Irva Hertz-Picciotto, Harvey J. Kliman
Source : www.biologicalpsychiatryjournal.com

Le placenta pourrait prédire le risque d'autisme
Les résultats de cette étude suggèrent que les enfants nés de femmes porteuses de placenta ayant une augmentation des inclusions trophoblastiques seraient à risque élevé d'autisme. Si aucun des placentas du groupe témoin n'avait plus de deux inclusions, le taux observé dans le groupe à risque était huit fois plus élevé. Leurs identifications donneraoi la possibilité d'identifier les nouveau-nés à risque de TSA qui pourraient bénéficier d'interventions précoces ciblées visant à prévenir ou atténuer les symptômes comportementaux et optimiser les résultats de développement.

Background
Gestation is a critical window for neurodevelopmental vulnerability. This study examined whether the presence of trophoblast inclusions (TIs) in the placenta could serve as a predictor for children at elevated risk for autism spectrum disorder (ASD).

Methods
Placentas were obtained from 117 births in the MARBLES (Markers of Autism Risk in Babies—Learning Early Signs) cohort of families who have one or more previous biological children with ASD, placing their newborn at elevated risk for neurodevelopmental compromise. Control samples were obtained from 100 uncomplicated term pregnancies of multiparous women with one or more typically developing biological children. Frequency of TIs was compared across the two groups.

Results
Placentas from at-risk pregnancies had an eightfold increased odds of having two or more TIs compared with control samples (odds ratio: 8.0, 95% confidence interval: 3.6–18.0). The presence of=2 TIs yielded a sensitivity of 41% and a specificity of 92% for predicting ASD risk status, whereas=4 TIs yielded a sensitivity of 19%, a specificity of 99.9%, and a positive likelihood ratio of 242 and conservatively predicted an infant with a 74% probability of being at risk for ASD.

Conclusions
Our findings suggest that the placentas from women whose fetuses are at elevated risk for autism are markedly different from control placentas. These differences are manifested histologically as TIs. Their identification has the possibility of identifying newborns at risk for ASD who might benefit from targeted early interventions aimed at preventing or ameliorating behavioral symptoms and optimizing developmental outcomes.

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