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Risk factors for autism spectrum disorder in the Thai population

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Abstract

Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental disorder commonly prevalent in children worldwide including Thailand. However, there are very few studies thus far addressing risk factors for ASD in Thai children. This case-control study aims to investigate whether various risk factors especially socioeconomic status, advanced parental age (age >35 years), perinatal factors, maternal autoimmune diseases, and family history of neuropsychiatric illnesses were associated with the risk of having an offspring with ASD. There were 235 children with ASD (age 8.44 ± 3.37 years) and 235 controls (age 8.39 ± 3.37 years) enrolled in this study. The risk of developing ASD in these children included advanced paternal age (adjusted odds ratio (AOR) = 3.49, 95 % confidence interval (CI) = 2.05–5.96), family history of neuropsychiatric illnesses particularly if such disorders came from the paternal side of the child’s family (AOR = 2.87, 95 % CI = 1.29–6.39), and having unemployed mothers (AOR = 1.65, 95 % CI = 1.08–2.54).

Conclusion: This study supports previous findings of Western countries where risk factors for ASD tend to occur in children whose fathers were of advanced paternal age and in the families with neuropsychiatric illnesses particularly if such disorders came from the paternal side of the child’s family.

What is Known:

• Family history of neuropsychiatric disorders and advanced paternal age are risk factors for ASD in the offspring previously identified in the studies in Europe and North America.

What is New:

• To our knowledge, this is the first study documenting risk factors for ASD in the Asian population.

• Our study supports previous findings of Western countries where risk factors for ASD tend to occur in the families with neuropsychiatric illnesses particularly if such disorders came from the paternal side of the child’s family.

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Abbreviations

ADHD:

Attention-deficit/hyperactivity disorder

AOR:

Adjusted odds ratio

ASD:

Autism spectrum disorder

CI:

Confidence interval

DSM-IV-TR:

Diagnostic and Statistical Manual of Mental Disorders-fourth edition-text revision

DSM-5:

Diagnostic and Statistical Manual of Mental Disorders-fifth edition

KCMH:

King Chulalongkorn Memorial Hospital

ORs:

Odds ratios

PDDSQ:

Pervasive Developmental Disorder Screening Questionnaire

SD:

Standard deviation

SH:

Saraburi Hospital

SLE:

Systemic lupus erythematosus

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Acknowledgments

We are very grateful to all participants and their families recruited in this study; the support given by the faculty and staff at the Division of Growth and Development, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, and at the Department of Child and Adolescent Psychiatry, Saraburi Hospital, Saraburi, Thailand; Associate Professor Chitsanu Pancharoen for his help on participant enrollment; Miss Sirinya Teeraananchai for her great help on statistical consultation; and finally Dr. Juthamas Worachotekamjorn for her helpful comments and suggestion on our manuscript.

This study was supported by the grant from Ratchadapiseksompotch Fund, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand (Grant No. RA56/035).

Compliance with Ethical Standards

ᅟ

Conflict of interest

The authors declare that they have no financial relationship with the organization that sponsored the research.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the Institutional Review Board of Faculty of Medicine, Chulalongkorn University, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent and assent was obtained from each parent and individual participant with the age of 7 years and older, respectively.

Authors’ contributions

Chusana Khaiman was responsible for conception and design of the study, literature search, participant enrollment, data collection and analysis, drafted the manuscript, and approved the final manuscript. Kanchana Onnuam was involved in participant enrollment, collected the data at Saraburi Hospital, and approved the final manuscript. Siripraphar Photchanakaew made the final diagnosis of ASD and supervised the data collection at Saraburi Hospital, and also approved the final manuscript. Weerasak Chonchaiya conceptualized and designed the study, made the final diagnosis of ASD at King Chulalongkorn Memorial Hospital, supervised the data collection and analyses, drafted and performed critical revision of the manuscript for important intellectual content, and approved the final manuscript. Kanya Suphapeetiporn conceptualized and designed the study, supervised the data collection and analyses, performed critical revision of the manuscript for important intellectual content, and approved the final manuscript.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

    Chusana Khaiman

  2. King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand

    Chusana Khaiman, Weerasak Chonchaiya & Kanya Suphapeetiporn

  3. Department of Child and Adolescent Psychiatry, Saraburi Hospital, Saraburi, Thailand

    Kanchana Onnuam & Siripraphar Photchanakaew

  4. Division of Growth and Development, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Sor Kor Building 11th Floor, Bangkok, 10330, Thailand

    Weerasak Chonchaiya

  5. Division of Medical Genetics and Metabolism, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

    Kanya Suphapeetiporn

Authors
  1. Chusana Khaiman
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  2. Kanchana Onnuam
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  3. Siripraphar Photchanakaew
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  4. Weerasak Chonchaiya
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  5. Kanya Suphapeetiporn
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Corresponding author

Correspondence to Weerasak Chonchaiya.

Additional information

Communicated by Peter de Winter

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Khaiman, C., Onnuam, K., Photchanakaew, S. et al. Risk factors for autism spectrum disorder in the Thai population. Eur J Pediatr 174, 1365–1372 (2015). https://doi.org/10.1007/s00431-015-2544-2

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  • DOI: https://doi.org/10.1007/s00431-015-2544-2

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