Below are news releases and briefs on statements appearing in the April ssue of Pediatrics, the peer-reviewed, scientific journal of the American Academy of Pediatrics (AAP).

MENTAL DISORDERS IN PARENTS LINKED TO AUTISM IN CHILDREN

Parents of children with autism were roughly twice as likely to have been hospitalized for a mental disorder, such as schizophrenia, than parents of other children, in an analysis of Swedish birth and hospital records. The study, "Parental Psychiatric Disorders Associated With Autism Spectrum Disorders in the Offspring," examined 1,237 children born between 1977 and 2003 who were diagnosed with autism before age 10, and compared them with 30,925 control subjects matched for gender, year of birth and hospital. Previous research has found psychiatric disorders are more common among family members of individuals with autism, a finding replicated in this study. The large sample size of this study enabled researchers to distinguish between psychiatric history among mothers versus fathers in relation to autism. Both mothers and fathers with schizophrenia were about twice as likely to have a child diagnosed with autism. For other disorders, including depression and neurotic and personality disorder, an association with childhood autism was found only for maternal disorders, not for paternal disorders. The association was present regardless of the timing of the parent?s diagnosis relative to the child's diagnosis. The results support the hypothesis that there is a familial predisposition that presents differently in the parent than in the child and probably requires other genetic or environmental factors to be expressed.

[Embargoed until Monday, May 5, at 12:01 a.m. ET. For more information, contact Ramona DuBose at 919-966-7467 or ramona_dubose@unc.edu ]

TEEN DRIVERS RECOGNIZE MANY, BUT NOT ALL, RISKS

With prom season and summer vacation just around the corner, teen drivers may find themselves in any of a long list of unsafe driving situations. A survey of more than 5,000 high school students examined teen attitudes about 25 risky driving situations and identified important gaps in their perceptions about factors that can lead to accidents. According to the study, "National Young-Driver Survey: Teen Perspective and Experience With Factors That Affect Driving Safety," 60 percent of teens believed inexperience heavily influences safety, but did not consider their peers to be inexperienced. Teens also revealed important nuances in the way they ranked distractions: 10 percent recognized passengers as a potential hazard, but more acknowledged that passengers who acted in certain ways posed a risk. Similarly, the respondents did not consider cell phones particularly risky unless their use evoked certain emotional responses. The study also revealed that certain subgroups of teens are not receiving adequate education about risks such as speeding, and drinking and driving. Caucasian youth viewed speeding as less risky, while reporting they see it more often among their peers than African American and Hispanic youth did. Meanwhile, African American and Hispanic youth viewed drinking alcohol while driving as less risky, and reported seeing it more often among their peers than did Caucasian youth. Adults who are equipped with these insights into teens' perceptions may be better positioned to reach them with messages about safe driving.

[Embargoed until Monday, May 5, at 12:01 a.m. ET. For more information, contact Dana Mortensen, at mortensen@email.chop.edu or (267-426-6092)]

THE SAFEST SEAT: APPROPRIATE CHILD SAFETY SEAT PLACEMENT

Child safety seats installed in the rear seat of a motor vehicle protect children in motor vehicle crashes. Recent advances in child-restraint system (CRS) design and changing patterns of child safety seat use have prompted the need to reevaluate the evidence in support of these recommendations. In the study, "Seating Patterns and Corresponding Risk of Injury Among 0- to 3-Year-Old Children in Child Safety Seats," the most common seating position for children using a CRS is the rear passenger side. Use of this position increases as children get older. However, child occupants aged 0-3 years seated in the center rear had a 43 percent lower injury risk compared with children in either of the rear outboard positions. Study authors offer updated evidence for the current recommendations that the center rear is the safest seat position for children restrained in a CRS, but they do not indicate that a child seated in an outboard position is a poor choice. Rather, they suggest that installing a CRS in the center rear position further reduces the risk of injury and enhances the protection already offered by child safety seats installed in the outboard position.

[Embargoed until Monday, May 5, at 12:01 a.m. ET. For more information contact Dana Mortensen from The Children?s Hospital of Philadelphia at 267-426-6092 or mortensen@email.chop.edu ]

HEART HORMONE HIGHER IN CHILDREN WHO SNORE AND WET THE BED

Children who snore are more likely to wet the bed during the night and also have higher levels of a heart hormone that helps regulate fluids in the body, according to the study, "Increased Morning Brain Natriuretic Peptide Levels in Children with Nocturnal Enuresis and Sleep-Disordered Breathing: A Community-Based Study." Researchers collected surveys about the sleeping habits of children ages 5 to 7 in 17,646 families in Kentucky. A subset of 378 children also underwent sleep studies in a lab, where researchers measured their breathing, heart rate, oxygen saturation, sleep position, blood samples and bed wetting. In the study, nearly 27 percent of children who snored also wet the bed, compared to 11.6 percent of children who didn?t snore. The frequency of bed-wetting among snoring children was not affected by the severity of sleep disordered breathing. However, bed-wetters did have elevated morning levels of brain natriuretic peptide (BNP), a hormone synthesized in the heart that can be an indicator of heart function. BNP increases sodium and water excretion and inhibits other hormones that regulate fluids in the body. The authors suggest that sleep fragmentation and the release of BNP may contribute to bed-wetting among children who snore.

[Embargoed until Monday, May 5, at 12:01 a.m. ET. For more information, contact David Gozal, MD, 502-852-2323, david.gozal@louisville.edu or Leila Kheirandish-Gozal, 502-852-5262, l0kheio1@gwise.louisville.edu ]

CHILDREN WITH DIABETES SHOW ACCELERATED TOOTH ERUPTION

In addition to being a risk factor for gum disease, diabetes mellitus can cause accelerated tooth eruption in children, according to the study "Accelerated Tooth Eruption in Children with Diabetes Mellitus." Researchers studied 270 children ages 6 to 14 with diabetes (primarily type 1 diabetes) and 320 healthy children in the same age range. Participants answered questions about their medical and dental history and had regular dental exams. Among children ages 10 to 14, those with diabetes had accelerated dental development compared to healthy children. A higher body mass index and gingival inflammation were also associated with expedited tooth eruption, a process that starts with teeth emerging from the gums and moving into their final positions in the mouth. It is unknown whether such aberrations in eruption lead to a greater risk for dental crowding or orthodontic care in children. For now, the authors suggest a greater emphasis on regular dental care aimed at health promotion and disease prevention, especially in children with diabetes mellitus.

[Embargoed until Monday, May 5, at 12:01 a.m. ET. For more information, contact Shantanu Lal, DDS, 212-305-1041, SL784@columbia.edu or Ira B. Lamster, DDS, MMSc, 212-305-4511, IBL1@columbia.edu ]

Editor's note: The May issue includes two other studies related to diabetes: "Obesity and Type 2 Diabetes Risk in Midadult Life: The Role of Childhood Adversity,? and ?Presence of Diabetic Ketoacidosis at Diagnosis of Diabetes Mellitus in Youth."

CHILDHOOD EPILEPSY AND MATERNAL INFECTIONS

Epilepsy, a disorder of the nervous system characterized by recurrent seizures, affects 1 percent of the population before the age of 20. Less than 20 percent of these cases have a known cause, but maternal infections have been associated with an increased risk of some neurological disorders. In "Prenatal Exposure to Maternal Infections and Epilepsy in Childhood: A Population-Based Cohort Study," researchers studied 90,619 children for up to eight years and diagnosed 646 children with epilepsy. Children exposed to some maternal infections during pregnancy (bladder infection, diarrhea, cough or vaginal yeast infection) had an increased risk for epilepsy in childhood. The mechanisms underlying the associations remain unsettled. The research group is planning another study to explore the possible mechanisms and replicate the findings by using biomarkers of infection. If the findings are causal, they have implications on the etiology and prevention of childhood epilepsy.

[Embargoed until Monday, May 5, at 12:01 a.m. ET. For more information, contact Yuelian Sun, MD, at the Department of Epidemiology, University of Aarhus, Denmark, at (45) 8942 6111 or ys@soci.au.dk or Jorn Olsen, Professor and Chair, UCLA School of Public Health at 310-825-3516 or jo@ucla.edu ]

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The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well being of infants, children, adolescents and young adults.