Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by difficulties in social interaction, repetitive behaviors, and narrow interests. People with ASD often experience additional mental health issues such as depression and anxiety. While genetics have long been considered a significant factor in the development of ASD, recent research indicates that the interplay between genes and the environment is crucial in understanding its underlying causes. This chapter aims to discuss the relationship between prenatal stress and the characteristics of ASD in countries within the Asia-Pacific region. The findings indicate a connection between prenatal stress and the traits of ASD in China, South Korea, and Japan. Further investigation is required to fully comprehend the specific mechanisms involved in this relationship. Genetic consultation can provide insights into potential risk factors, genetic counseling, and guidance on personalized interventions.
TopIntroduction
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by impaired communication, social deficits, and repetitive behaviors. It affects 1 in 59 children (approximately 1.7%) in the USA, and 1 in 143 in China as of 2020 (Leigh & Du, 2015; Zhou et al., 2020). The incidence of ASD among children born in Japan who were diagnosed with the disorder between 2009 and 2014 was 2.75%, whereas the total prevalence of ASD among Koreans increased from 5.04 per 100,000 in 2008 to 10.97 per 100,000 in 2015 (Sasayama et al., 2021). Whereas the total prevalence of ASD among Koreans was 5.04 per 100, 000 in 2008 and increased to 10.97 per 100, 000 in 2015 (Hong et al., 2020). These findings indicate a rising prevalence of ASD, particularly in the United States and Asia-Pacific regions, encompassing countries such as China, Japan, and South Korea. The social dynamics and cultural norms vary across the United States, China, Japan, and South Korea. Cultural variables can vary even within a single country.
Nevertheless, expectant mothers frequently encounter social, economic, physical, and psychological challenges and burdens during pregnancy, particularly in both industrialized and developing nations (Furber et al., 2009). In contemporary society, individuals are required to balance self-care, work responsibilities, and simultaneous childcare duties (Kim & Chung, 2018). In China, Japan, and South Korea, there has been a notable increase in the number of pregnant women who are engaging in employment to provide support for their families. Moreover, it stands apart from previous generations due to the substantial changes in work culture that have taken place. The stress experienced by these women is influenced by several complex factors, including physical and psychological changes, managing daily life, maternal and infant health, maternal role, family support, healthcare services, social environment, and the challenge of balancing work and pregnancy responsibilities for those who are working (Kim & Chung, 2018). Recent research conducted in Japan revealed that pregnant women encounter limited social support and heightened pain intensity throughout their pregnancy (Yamada et al., 2021). China is rapidly emerging as a highly progressive nation in the Asia-Pacific region, experiencing significant growth and development.
The prevalence of psychiatric problems such as depression, anxiety, and stress during pregnancy was high in Chinese pregnant women (Gao et al., 2019; Hu et al., 2017; Ma et al., 2019; Wu et al., 2020). In China, where the prevalence of depression, anxiety, and stress during pregnancy is high, the main stress factors include lower educational backgrounds, unplanned pregnancies, crowded residential conditions, lower household income, and a greater number of previous deliveries, as well as poor sleep quality (Gao et al., 2019; Hu et al., 2017). Pregnant women are at high risk of prenatal stress, depression, and anxiety during early pregnancy (Tang et al., 2019), even during the COVID-19 period, as evidenced by research papers published between 2019-2021 (Luo et al., 2021; Rodriguez et al., 2021; Uludag, 2022; Wang et al., 2020; Zhang et al., 2021).
Key Terms in this Chapter
Psychopathology: The study of abnormal behaviors and mental disorders. In the context of this paper, it refers to the potential developmental and psychological disorders that can arise as a result of prenatal stress or other factors related to ASD.
Microglia: Specialized immune cells located in the brain and spinal cord, part of the central nervous system's immune defense. They play a key role in brain maintenance, including the removal of damaged neurons and infection control, and have been implicated in the pathology of various neurodevelopmental disorders.
Neurodevelopmental Disorders: A group of disorders that affect the development of the nervous system, leading to abnormal brain function which may affect emotion, learning ability, self-control, and memory. ASD falls under this category.
Autism Spectrum Disorder (ASD): A neurodevelopmental disorder characterized by challenges with social interaction, and communication, and often accompanied by repetitive behaviors. ASD encompasses a range of conditions that were previously considered separate – autism, Asperger's syndrome, childhood disintegrative disorder, and an unspecified form of pervasive developmental disorder.
Cortisol: A steroid hormone produced by the adrenal glands, often referred to as the “stress hormone” as its levels increase in response to stress. It plays a crucial role in regulating various bodily functions including metabolism, immune response, and stress responses.
Prenatal Stress: The stress experienced by a pregnant woman, can have significant impacts on the fetus's development. This stress can be psychological or physiological and is known to affect both the mother and the developing fetus, potentially leading to long-term health and developmental consequences.
Genetic Counseling: A process that involves analyzing and advising individuals about the genetic risks and implications of inherited disorders. It helps individuals understand and adapt to the medical, psychological, and familial implications of genetic contributions to diseases.