Risk Factors for Autism: Perinatal Factors, Parental Psychiatric History, and Socioeconomic Status

Department of Epidemiology and Social Medicine, Aarhus University, Aarhus, Central Jutland, Denmark
American Journal of Epidemiology (Impact Factor: 5.23). 05/2005; 161(10):916-25; discussion 926-8. DOI: 10.1093/aje/kwi123
Source: PubMed


Research suggests that heredity and early fetal development play a causal role in autism. This case-control study explored the association between perinatal factors, parental psychiatric history, socioeconomic status, and risk of autism. The study was nested within a cohort of all children born in Denmark after 1972 and at risk of being diagnosed with autism until December 1999. Prospectively recorded data were obtained from nationwide registries in Denmark. Cases totaled 698 children with a diagnosis of autism; each case was individually matched by gender, birth year, and age to 25 controls. Analyses by conditional logistic regression produced risk ratios and 95% confidence intervals. Adjusted analyses showed that the risk of autism was associated with breech presentation (risk ratio (RR) = 1.63, 95% confidence interval (CI): 1.18, 2.26), low Apgar score at 5 minutes (RR = 1.89, 95% CI: 1.10, 3.27), gestational age at birth <35 weeks (RR = 2.45, 95% CI: 1.55, 3.86), and parental psychiatric history (schizophrenia-like psychosis: RR = 3.44, 95% CI: 1.48, 7.95; affective disorder: RR = 2.91, 95% CI: 1.65, 5.14). Analyses showed no statistically significant association between risk of autism and weight for gestational age, parity, number of antenatal visits, parental age, or socioeconomic status. Results suggest that prenatal environmental factors and parental psychopathology are associated with the risk of autism. These factors seem to act independently.

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    • "This study aims to examine the relationship of a specific medical condition—namely, premature birth—with age of first concern. Premature birth has been indicated as a significant risk factor for ASD (Abel et al., 2013; Buchmayer et al., 2009; Dodds et al., 2011; Hultman, Sparén, & Cnattingius, 2002; Hwang, Weng, Cho, & Tsai, 2013; Larsson et al., 2005; Mamidala et al., 2013). Research has also indicated that children with ASD born prematurely may have more severe symptoms than those born later in gestation (Abel et al., 2013; Movsas & Paneth, 2012). "
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    ABSTRACT: The current study examines the relationship between premature birth and the age at which caregivers first become concerned with their child's development in a sample of 84 toddlers with autism spectrum disorder (ASD). The participants were split into two groups: those born prematurely and those born full term. The results indicate that the age of caregiver first concern is significantly younger for those born prematurely than those born full term. The average age caregivers reported first becoming concerned about their child's development was around 7 months for participants born prematurely and around 13 months for participants born full term. Possible explanations for the results and their implications are discussed.
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    • "Interestingly, premature birth was not found to be related to screening refusal. Previous research on the relationship between birth weight and ASD are mixed, with some results indicating that low birth weight increases risk for ASD (Lampi et al. 2012; Losh et al. 2012; Schendel and Bhasin 2008), while others have not (Larsson et al. 2005). Schendel and Bhasin (2008) "
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    ABSTRACT: Emerging evidence of the efficacy of early intervention for autism spectrum disorder (ASD) has focused attention on the need for early identification of young children suspected of having ASD and thus on the implementation of routine ASD screenings. This study examined the refusal rates of ASD screening among infants and toddlers enrolled in EarlySteps, the State of Louisiana’s early intervention program. Participants (n = 4,296) were children aged from birth to 36 months who were enrolled in EarlySteps. The Battelle Developmental Inventory, Second Edition (BDI-2) and demographic section of the Baby and Infant Screen for Children with aUtism Traits- Part 1 (BISCUIT: Part 1) were administered to a parent or caregiver as part of the EarlySteps assessment protocol. ASD screenings were refused by 23.3 % of children sampled. Females were found to be at greater risk for screening refusal (adjusted odds ratio (OR) = 1.338, 95 % CI 1.106–1.618). African American children were less likely to have screening refused than other ethnicities (OR = .746, CI 95 % .609–.915). Previous diagnoses of Down syndrome (OR = 3.934, 95 % CI 1.785–6.462), cerebral palsy (OR = 2.744, 95 % CI 1.436–5.243), seizure disorders (OR = 2.271, 95 % CI 1.208–3.638), and other genetic conditions (OR = 2.271, 95 % CI 1.273–4.052) were also found to increase risk of refusal. Children with a family history of ASD were less likely to have screening refused (OR = .351, 95 % CI .244–.505). Clinical applications and the need for more research on factors related to ASD screening refusal are highlighted.
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    • "Research has provided some evidence with the finding that women taking antidepressant (Croen et al. 2011) or anticonvulsant medication (Christensen et al. 2013; Maimburg and Vaeth 2006) during pregnancy were more likely to have a child with ASD. Others have suggested that the children of parents with a psychiatric disorder might be more likely to be diagnosed with ASD than the children of other parents because of the closer contact of the former group with diagnosticians (Larsson et al. 2005). Furthermore, women with a psychiatric disorder may have lower levels of self-care than other women (Lawrence et al. 2010). "
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    ABSTRACT: Psychiatric disorders are more common in the mothers of children with autism spectrum disorder (ASD) or intellectual disability (ID) after the birth of their child. We aimed to assess the relationship between women's psychiatric contacts and subsequent offspring with ASD/ID. We linked three Western Australian registers to investigate pre-existing maternal outpatient psychiatric contacts and the odds of ASD/ID in a subsequent child. Women with a previous outpatient psychiatric contact were more than twice as likely to have a child with ASD [OR 2.07 (95 % CI 1.7, 2.6)] or ID [OR 2.31 (2.1, 2.6)]. Further research exploring the effect on pregnancy outcomes of medications prescribed to women with psychiatric disorders is implicated.
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