Risk Factors of Autistic Spectrum Disorders (ASDs) in a group of Egyptian Children Attending Psychiatric Clinic of Postgraduate Childhood Studies Institute, Ain Shams University

Abstract

Autism Spectrum Disorder (ASD) is defined as range of complex neurodevelopmental disorders, characterized by impairments in social and communication skills as well as restricted, repetitive, and stereotyped patterns of behaviour and movement. (American Psychiatric Association, 2013) Autism is caused by a combination of genetic and environmental factors influencing early brain development. The clearest evidence of these autism risk factors involves prenatal, natal and postnatal events. They include advanced parental age at time of conception, maternal illness during pregnancy and certain difficulties during birth, particularly postnatal hypoxia. (Gardner et al., 2011) Families having autistic children face many challenges like the disruptive, antisocial behaviour of autistic child, high levels of parental stress, marital dysfunction and financial problems. (Bashir, 2014)

The Objective of the current study is to:  Identify possible risk factors of autistic spectrum disorders.  Describe emotional, social and financial impacts of autistic children on their family members. The current study is a case-control study. The autistic children were recruited from Postgraduate Childhood Studies Institute affiliated to Ain Shams University and the typically developing children were recruited from outpatient Pediatric clinics of the Ain Shams University hospital. Both cases and controls were matched regarding age and sex. A total of 142 caregivers of the children answered an interview questionnaire which consisted of two sections; the first section was risk factors for ASD by a structured questionnaire for cases and controls (71 case, 71 controls) and the second one was the impact of autistic children by Impact on Family Scale for cases only (71 case). Main study findings show that there were statistically significant differences between cases and controls regarding number of siblings, education of both parents, age of father at conception, family income, family history of psychiatric diseases, artificial feeding, factors related to pregnancy (hypertension during pregnancy, folic Acid supplementation during first trimester) and neonatal factors (postnatal hypoxia, admission to NICU, period of admission and cause of admission). After applying logistic regression model, the variables that affected ASD were positive family history (OR=8.26), postnatal hypoxia (OR= 4.79) and folic acid supplementation during 1st trimester of pregnancy (OR=0.21). Furthermore, the current study showed that most of the cases (56.3%) started their autistic symptoms between two to three years and there were delayed developmental milestones in autistic children. Also, there were statistically significant differences between cases and controls regarding admission to school, type of education and pica. The current study also revealed that factors affecting the Impact on Family Scale were order of birth of autistic child, number of siblings, marital status, saying a word, admission to school, sad autistic child, and Autistic child improvement.