Main Article Content
Background The prevalence of autistic spectrum disorder
(ASD) has increased in recent decades. The definitive causes
of ASD have yet to be recognized. Howevei; it is believed that
both genetic and non-genetic, as well as perinatal and post natal
factors influence ASD. Previous studies have shown inconsistent
Objectives To assess for prematurity, birth weight, asphyxia,
mode of delivery, bleeding during pregnancy, parental age and
education, as prognostic factors for ASD.
Methods We conducted a cross sectional study at schools for
autistic children in Yogyakarta between February 2011 to October
2012. The inclusion criteria were children with and without ASD,
whose parents consented to participate in this study. Children
with genetic abnormalities or who planned to move away during
the study period were excluded. A total of 48 subjects with ASD
and 96 subjects without ASD were involved in this study. Data
were obtained by direct interview using questionnaires. Logistic
regression analysis was performed to examine the hypoth esis.
Results Multivariate analysis showed that prematurity was not
a significant prognostic factor (RR 2.73; 95%CI 0.3 to 15.7) for
ASD. Howevei; children born by Caesarean section were 5.4 times
more likely to have ASD (RR 5.4; 95%CI 1.3 to 22.8) compared
to those who were delivered vaginally or by vacuum extraction.
Moreovet; asphyxia was also a significant prognostic factor for
ASD (RR 8.7; 95%CI 1.9 to 38.6) .
Conclusion Prematurity is not a risk factor for ASD. Asphyxia
and Caesarean birth should be considered as potential confounders
in this study.
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2. Ritvo ER, Freeman BJ, Pingree C, Mason-Brothers A, Jorde L, Jenson WR, et al. The UCLA-University of Utah Epidemiologic Survey of Autism: prevalence. Am J Psychiatry 1989;146:194-9.
3. California Department of Developmental Services. Autistic spectrum disorder: Changes in the California caseload: An update 1999 through 2002. [cited ?]. Available from: http://www.dds.ca.gov/Aurism/docs/AurismReport2003.pdf. p.1-24.
4. Altevogt BM, Hanson SL, Leshner AI. Autism and the environment: challenges and opportunities for research . Pediatrics. 2008;121:1225-9.
5. Lotter V. Epidemiology of autistic con ditions in young children. Social Psychiatry.1966;1:124-37.
6. Baird G, Charman T, Baron-Cohen S, Cox A, Swettenham J, Wheelwright S, et al. 2000. A screening instrument for autism at 18 months of age: a 6-year follow-up study. J Am Acad Child Adolesc Psychiatry. 2000;39:694-702.
7. American Psychiatric A ss ociation. Diagn stic and statistical manual of mental disorder IV-TR. 4th ed. Arlington, VA:American Psychiatric Association; 2000.
8. Pusponegoro HD. Penyebab dan neuropatologi aurisme. In: Lokakarya penatalaksanaan anak aurisrik. Jakarta. 1999. p.1-5
9. Lauritsen MB, Pedersen CB, Mortensen PB. Effects of familial risk factors and place of birth on the risk of autism: a nationwide register-based study. J Child Psychol Psychiatry. 2005;46:963-71
10. Kolevzon A, Gross R, Reichenbeg A. Prenatal and perinatal risk factors for autism: A review and integration of findings. Arch Pediatr Adolesc Med. 2007;161:326-33.
11. Fombonne E. Epidemiology of autistic disorder and other pervasive developmental disorders. J Clin Psychiatry. Montreal, QC: Plenum Publishing Corporation. 2005;66:3-8.
12. Shah PE, Dalton R, Boris N. Pervasive developmental disorders and childhood psychosis. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, PA:Saunders Elsevier; 2007. p. 133-6.
13. Pfaff DW, Rapin I, Goldman S. Male predominance in autism: neuroendocrine influences on arousal and social anxiety. Autism Res. 2011;4:163-76.
14. Lanson HJ, Eaton WW, Madsen KM, Vestergaard M, Olesen AV, Agerbo E, et al. Risk factors for autism: perinatal factors, parental psychiatric history, and socioeconomic status. Am J Epidemiol. 2005;161:916-25.
15. Reichenberg A, Gross R, Weiser M, Bresnahan M, Silverman J, Harlap S, et al. Advancing paternal age and autism. Arch Gen Psychiatry. 2006;63:1026-32.
16. Mason-Brothers A, Ritvo ER, Pingree C, Petersen PB, Jensen WR, McMahon WM, et al. The UCLA-University of Utah epidemiologic survey of autism: prenatal, perinatal, and pos tnatal factors. Pediatrics. 1990;86:514-9.
17. Szatmari P, Zwaigenbaum L, Bryson S. Conducting generic epidemiology studies of autism spectrum disorders: issues in matching. J Autism Dev Disord. 2004;34:49-57.
18. Zwaigenbaum L, Thurm A, Stone W, Baranek G, Bryson S, Iverson J, et al. 2007. Studying the emergence of autism spectrum disorders in high-risk infants: methodological and practical issues. J Autism Dev Disord. 2007;37:466-80.
19. Eaton WW, Mortensen PB, Thomsen PH, Frydenberg M. Obstetric complications and risk for severe psychopathology in childhood. J Autism Dev Disord. 2001;31:279-85.
20. Hultman CH, Sparen P, Cnattingius S. Perinatal risk factors for infantile autism. Epidemiology. 2002;13:417-23.
21. Muhartomo H. Faktor-faktor risiko yang berpengaruh terhadap kejadian aurisme [master thesis]. [Semarang] : Universitas Diponegoro; 2004. p. 67.
22. Bilder D, Pinborough-Zimmerman J, Miller J, McMahon W. 2009. Prenatal, perinatal and neonatal factors associated with autism spectrum disorder. Pediatrics. 2009;123:1293-300.
23. Murray RM, Harvey I. The Congenital origins of schizophrenia. Psychiatr Ann. 1989; 19:525-29
24. Schendel D, Bhasin TK. Birth weight and Gestational Characteristics of children with Autism, including a comparison with other developmental disabilities. Pediatrics. 2008;121:1155-64.