EPIDEMIOLOGICAL PROFILE AND RISK FACTORS ASSOCIATED WITH AUTISM SPECTRUM DISORDER IN CHILDREN ATTENDING A TERTIARY CARE CENTER IN NORTHERN INDIA: A CASE-CONTROL STUDY

Abstract

Background: Autism Spectrum Disorder (ASD) is a multifactorial neurodevelopmental disorder, with both genetic and environmental influences. In developing countries, limited data exist on the role of potentially modifiable perinatal and environmental factors in the etiology of ASD, underscoring the need for focused assessments and management in this area.

Objective: To identify epidemiological and risk factors associated with ASD in children, comparing them to controls at a tertiary care center in Northern India.

Methods: This retrospective case-control study was conducted over 18 months at a tertiary care center. Seventy-five children aged 2–12 years were enrolled, including 50 with ASD (Group A), diagnosed per DSM-V criteria, and 25 age-matched healthy controls (Group B). Detailed demographic, perinatal, postnatal, and environmental data were collected. Statistical analysis was performed using chi-square and t-tests, with p<0.05 considered significant.

Results: Significant associations with ASD were found for high socioeconomic status (p=0.007), nuclear family structure (p=0.007), history of abortion (p=0.004), maternal systemic illness (p=0.024), and maternal drug intake during pregnancy (p=0.031). Delayed crying at birth was more frequent in the ASD group (14%; p=0.049). Early screen exposure (<1 year) and prolonged screen time (>3 hours/day) were highly associated with ASD (p<0.001). Although not all were statistically significant, higher rates of inadequate sleep, non-exclusive breastfeeding, and vegetarian diet were observed in children with ASD.

Conclusion: The study highlights significant modifiable risk factors, particularly early screen exposure and maternal health issues linked to ASD. Targeted early interventions may reduce risk and improve outcomes.