PM356. Maternal lifestyle within 24 hours before delivery may be linked to the autism epidemic

Objective: The objective of this study was to investigate the characteristics of language profiles according to whether or not Korean children with autism spectrum disorder (ASD) also have ADHD, and to examine the relationship with executive function. Methods: Participants in the study were boys with ADHD aged 6 to 11 years who visited the clinic from January 2012 to December 2013. In this study, 25 boys with ASD were included, and completed scales included the Korean version of Autism Diagnostic Interview-Revised (K-ADI-R), Korean version of Autism Diagnostic Observation Schedule (K-ADOS), Korean ADHD Rating Scale (K-ARS), and Korean-Conners’ Parent Rating Scale (K-CPRS). They also completed neuropsychological tests and assessed language profiles. Patients were categorized into two groups (with ADHD and without ADHD). T-test and Multivariate analysis of covariance (MANCOVA) was used for analysis. Results: Statistically, no difference was found in receptive and expressive language ability between the ASD groups with and without ADHD. However, a lower score in Test of Problem solving (TOPS) was observed for ASD with ADHD than for ASD without ADHD, with problem solving and finding cues showing significant differences. Conclusions: These findings suggest that language profiles in the ASD group without ADHD could be similar to those in the ASD group with ADHD, but comorbid ADHD could lead to more difficulty in linguistic ability for problem solving and could be related with executive function of the frontal lobe. Key Worlds: Autism Spectrum Disorder, Attention-Deficit Hyperactivity Disorder, Language, Executive Function. PM356 Maternal lifestyle within 24 hours before delivery may be linked to the autism epidemic Silvia Hoirisch-Clapauch, M.D., Maria Amelia Sayeg Porto, M.D., PhD., Antonio E. Nardi, M.D., PhD. Abstract Objective: Neonatal hypoglycemia, depriving neurons of their main energy source, is a risk factor for autism spectrum disorders. Neonatal glucose levels are inversely correlated with cord levels of C-peptide, a polypeptide secreted with insulin. Since insulin causes fat to be stored rather than used for energy, it is expected that chronic hyperinsulinemia would result in largefor-gestational-age neonates. Since many small-for-gestationalage neonates have hypoglycemia, we postulated that a strong stimulus for maternal insulin secretion close to delivery would also stimulate neonatal insulin secretion, causing neonatal hypoglycemia. Methods: The study included 155 expectant mothers with at least one of the following indicators of overstimulation of maternal insulin production: acanthosis, morbid obesity, any invasive bacterial infection within a week before delivery, systemic corticosteroid use within a week before delivery, inactivity within 24 hours before delivery (<40 minutes of housework, walking or any other moderate or intense physical activity), and high-carbohydrate intake within 24 hours before delivery (>75% of calories from carbohydrates or >50 g of glucose to correct iatrogenic hypoglycemia). The minimum glucose level of their 158 neonates, measured 1, 2 and 4 hours after birth, was correlated to the maternal indicators and to classical predictors of neonatal hypoglycemia, such as maternal diabetes, birth weight and gestational age at delivery. Significant predictors were entered into a logistic regression model to determine independent predictors. Results: Independent predictors were inactivity and high-carbohydrate intake. The risk of neonatal hypoglycemia increased fivefold with inactivity, 11-fold with high-carbohydrate intake and 329-fold with both parameters. Screening based on these maternal risk factors detected all hypoglycemic neonates identified by current screening strategies, plus five appropriatefor-gestational-age term neonates born to non-diabetic, slim mothers. Conclusion: Maternal lifestyle within 24 hours before delivery has a tremendous impact on neonatal glucose levels. Controlled studies are needed to determine whether physical activity combined with a balanced diet close to delivery can stop the autism epidemic.Objective: Neonatal hypoglycemia, depriving neurons of their main energy source, is a risk factor for autism spectrum disorders. Neonatal glucose levels are inversely correlated with cord levels of C-peptide, a polypeptide secreted with insulin. Since insulin causes fat to be stored rather than used for energy, it is expected that chronic hyperinsulinemia would result in largefor-gestational-age neonates. Since many small-for-gestationalage neonates have hypoglycemia, we postulated that a strong stimulus for maternal insulin secretion close to delivery would also stimulate neonatal insulin secretion, causing neonatal hypoglycemia. Methods: The study included 155 expectant mothers with at least one of the following indicators of overstimulation of maternal insulin production: acanthosis, morbid obesity, any invasive bacterial infection within a week before delivery, systemic corticosteroid use within a week before delivery, inactivity within 24 hours before delivery (<40 minutes of housework, walking or any other moderate or intense physical activity), and high-carbohydrate intake within 24 hours before delivery (>75% of calories from carbohydrates or >50 g of glucose to correct iatrogenic hypoglycemia). The minimum glucose level of their 158 neonates, measured 1, 2 and 4 hours after birth, was correlated to the maternal indicators and to classical predictors of neonatal hypoglycemia, such as maternal diabetes, birth weight and gestational age at delivery. Significant predictors were entered into a logistic regression model to determine independent predictors. Results: Independent predictors were inactivity and high-carbohydrate intake. The risk of neonatal hypoglycemia increased fivefold with inactivity, 11-fold with high-carbohydrate intake and 329-fold with both parameters. Screening based on these maternal risk factors detected all hypoglycemic neonates identified by current screening strategies, plus five appropriatefor-gestational-age term neonates born to non-diabetic, slim mothers. Conclusion: Maternal lifestyle within 24 hours before delivery has a tremendous impact on neonatal glucose levels. Controlled studies are needed to determine whether physical activity combined with a balanced diet close to delivery can stop the autism epidemic. PM357 Breastfeeding is associated with children’s learning ability in school-aged children Kyoungmin Kim1, Johanna Inhyang Kim1, Bung-Nyun Kim1, Jae-Won Kim1, Soon-beom Hong1, Soo-Chul Cho1 1Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul,