The Immunoreactive Factors and Metabolic Diseases as risk factors, at the Origin of Mental Diseases

A rather new world for those who do not regularly study the genetic, more acutely the immunoreactive factors by which someone could explain a great number of variations in the final expression of temperaments in many individuals, as it happens with the difficult child or adult or worse in autism, ADHD, conduct disorder.
At the beginning of life was an almost miracle. It could be compared to the Universe Big Bang, in the small infinite world. In a matter of days, weeks, billions of brain cells must develop in harmony, but not without a few victims of neurons or brain connections, during this totally invisible fight for life, between the mother and foetus survival.
Everyone knows about RH, ABO blood compatibility factors and how badly the consequences could be in pregnancies when there is one partner positive and another negative. Reject phenomena are at hand when it happens between the mother and the foetus. Lack of fertility is common on that basis. Or numerous abortions take place in the beginning days, without leaving any traces. In continuing pregnancy, nausea, vomiting, premature contractions, bleedings, and finally premature births are frequent, with brain immaturity, if not more brain damages already made in the newborn child.
Compatibility factors are more numerous that usually thought. The foetus is half a foreign body to the mother body and the male "Y" makes the situation worse adding another genetic differences. Because of the foreign part of father, the embryo is a half a transplant, subjected to a process of immunoreactive reactions from the mother who fights to defend herself from this foreign body. Antibodies are fast built to counterattack. In that perspective, fertility clinics are forcing the Mother Nature to bypass her natural defenses and make things happen, regardless of consequences. A women could not be fertile with a man, very probably, but with another one.
It is well known to clinicians that the oldest child and more often the boy, in a family, have more chances of suffering from physical or mental diseases. In psychiatry, autism, ADHD are 4-5 times more prevalent in boys than in girls. Only immune diseases are more often happening in females.
The conditions of the foetus maturity would mainly depend on this primitive and original incompatibility between parents, always present, always dangerous, being an invisible enemy. It could delay the optimal growth of the brain foetus and disturb or damage the neuro-psychic integrity or cognitive abilities, and even more so with the male.
To this fragile condition can be added some various environmental factors, as the use of drugs, alcohol, the deficit of basis foods, but among the worse and less publicized factor, the overeating that brings metabolic diseases like diabetes mellitus, starting from overweight to obesity, to pre-eclampsia or eclampsia and finally baldly foreseen delivery, with macrosomic foetus (over 8 pounds).
In Quebec, in 2007, there is no compulsory detection or medical prevention of gestational diabetes, neither there are routine pelvimetries to prevent long and suffering deliveries or brain anoxia. Moreover, the fashion, for young people, is now to go along with midwifes, with little medical knowledge. One of the most important events in life is left to much improvisation, regardless of the long-term consequences.
Here are clinical vignettes that combine both immunoreactive disorder and metabolic factors (overweight in pregnancy):
A 12 year old girl, Stephanie has been diagnosed ADHD, in a ADHD Research, 3 years ago and given neurostimulants. Mother had an abortion at 2.5 months at her first pregnancy and during the patient pregnancy; she had three bleedings with short hospitalizations. Plus, she took a 58 pounds gain of weight and delivered, at 37 weeks, a 8 pound 3 ounces baby.
The younger sister is seen as also ADD and is looking for an ADHD assessment. The patient is very opposing at home, but successful, although agitated and easily distracted, at school and very good in sports, like swimming and gym, giving 20 hours a week, in physical activities, since age 6 to spend her energy.
A 9 year old boy, Gabriel, is seen as a dysphasic kid, since the age of 4, having talk lately at age 4. An older brother, 14, was also given the diagnosis of dysphasia and a middle sister being seen as quite normal. The mother has a blood group "A negative" and father is "O positive". The pregnancy, 38.5 weeks, was difficult, with a gain of 50 pounds, causing important legs oedema. The newborn was at 7 pounds, 4 ounces. The child is timid but easily distracted, more ADD than ADHD.

Bibliography:
. An immunoreactive Theory of Selective Male Affliction, by Thomas Gualtieri et Robert E. Hicks, The Behavioral and Brain Sciences, 1985, 427-441.
. Maternal immune response to pregnancy, by Billington WD, Reprod Fertil Dev 1989, discussion 191.-Sex Differences in the Hyperkinetic Syndrome of Childhood, by A. James et E. Taylor, Journal of Child Psychiatry, 1989.
. Detection of Maternal Antibodies In Infantile Autism, par R.P.Warren, p.Cole et ass., J. Am.Acad.Child Adol. Psychiatry, 29:6, November 1990
. Specific diversity in the immunogenetic relationship between mother and fetus, by Billington WD, Exp Clin Immunogenet 1993; 10(2):73-84
. Controversies in the diagnosis and treatment of gestational diabetes. Jovanovic L Cleve Covering joint J Med (United States), Jul 2000, 67(7) p481-2, 485-6, 488
. Obesity, weight loss, and pregnancy outcomes.(Comment). Aaron B. Caughey. 
The Lancet, vol. 368.9542 (Sept 30, 2006): p1136(3).
This article comments on the study published in this magazine "Interpregnancy weight change and risk of adverse pregnancy outcomes: a population-based study," by Eduardo Villamor and Sven Cnattingius. The researchers were curious to see if there were connections between maternal obesity and complications during pregnancy. The study looked at the weight of women who were having their second baby. Women who were heavier tended to have more complications than those who were not. This study raises the questions of whether the problems of weight are because of immediate weight gain before the second pregnancy or because of lack of weight loss from the first and whether weight loss between the pregnancies is actually a preventative of complications.
Author Affiliations:
¹Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA 94143, USA

Claude Jolicoeur, m.d.