الفهرس 
Patients and MethodsOnly 14 pages are availabe for public view
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Abstract
Autism is a severe neurodevelopmental disorder characterized by impaired communication, social interaction and imagination that is often accompanied by repetitive and stereotyped behavior.
The present work aimed at studying the relationships between autism and some of parental, perinatal and neonatal risk factors in children with autistic disorder.
Patients and methods:
Our study included 50 children with autism, aged 3-12 years, all of them fulfilling the criteria of the Diagnostic and Statistical Manual of Mental Disorders (DSM–IV-TR) recruited from the Psychiatric Clinic, Institute of Postgraduate Childhood Studies, Ain Shams University and 50 age & sex matched apparently healthy children recruited from different outpatient clinics as control group.
The children were subjected to the following:
1. Clarification aim of the study to all parents after that a written informed consent obtained.
2. Detailed history taking including all the suspected risk factors in the prepared questionnaire.
3. General examination to all children with laying stress on neurological examination.
4. Confirmation of diagnosis using DSM-IV-TR criteria of autism for cases.
5. Assessment of the severity of the autistic disorder using the Childhood Autism Rating Scale (CARS) for cases.
This study revealed the following results:
The mean age of studied autistic children was 6.88 2.2 years, which is in accordance with the school age, while the mean age of control group was 6.561.98 years with no statistically significant difference of both group.
72% of the autistic samples were males, and 28% were females that reflect male to female ratio 2.5: 1 respectively.
CARS demonstrated that half of the sample (50%) scored severe degree ≥ 37, while (34%) moderate degree and (16%) mild degree.
High paternal age (≥35 years) at birth was found in 30% of autistic children in comparison to 10% of control group and the difference was statistically significant.
High maternal age (≥35 years) at birth was found in 22% of autistic children in comparison to 6% of control group and the difference was statistically significant.
No significant difference between cases and controls as regards parents’ consanguinity.
Regarding positive family history of psychiatric diseases in general, the difference was statistically insignificant.
As regards breech and other abnormal presentation during delivery 30% of autistic children were abnormal presented in comparison to 8% of control group, the difference was statistically significant.
History of caesarean section delivery was higher among cases (40%) than controls (20%) and the difference was statistically significant.
No significant difference between cases and controls as regards Elective (scheduled) caesarean sections in comparison to emergency caesarean sections.
As regards PROM, meconium stained amniotic fluid, prolonged labor, induced labor, precipitous labor, forceps extraction, vacuum extraction, umbilical cord complications and multiple gestations there were no significant difference between cases and controls.
As regards gestational age, premature autistic children (30%) were more than premature controls (8%) and the difference was statistically significant.
As regard birth weight, low birth weight <2500gm was statistically a significant risk factor of autism as 34% of cases were low birth weight <2500gm in comparison to 14% of control group.
Small for gestational age <10th percentile is not a significant risk factor of autism in the current study.
76% of autistic children were the first baby or last one in comparison to 44% of controls and the difference was statistically significant.
As regards history of delayed crying, positive resuscitation, neonatal hypoxia, neonatal respiratory complications, birth defects, neonatal congenital anomalies, neonatal sepsis, neonatal fever and neonatal seizures were statistically insignificant.
No significant difference between cases and controls as regards artificial feeding since birth.
As regard neonatal hyperbilirubinemia it was statistically significant as 30% of autistic children were complaining of neonatal jaundice in comparison to 6% of control group.
from the current study, we conclude the following:
1. Our findings support several perinatal, neonatal and parental risk factors of autism.
2. High parental age, high maternal age, breech and other abnormal presentation and caesarean delivery were identified as significant risk factors of autism
3. Preterm < 37 weeks of gestation, low birth weight < 2500 gm., 1st baby in the family and neonatal hyperbilirubinemia were identified as significant risk factors of autism.