Socio-demographic risk factors of autism spectrum disorder among children in a tertiary care hospital in Bangladesh: a case-control study

The risk factors associated with autism spectrum disorder (ASD) have been the subject of extensive research, though conclusive evidence remains elusive. This case-control study aimed to identify potential risk factors for ASD in children, conducted at the Department of Pediatric Neurology, National Institute of Neurosciences and Hospital, Dhaka, from July 2020 to June 2021. The study included 80 diagnosed ASD cases (ages 2-14 years) and 160 age- and sex-matched healthy controls. The findings indicated that the average paternal age was significantly higher in cases compared to controls (32.44 +/- 5.58 vs. 30.30 +/- 4.47 years). Additionally, there was a higher proportion of cases with a family history of ASD (5% vs. 0.6%), maternal antenatal stress (35 vs. 11.3%), and smoking exposure (15 vs. 1.9%), as well as neonatal factors such as seizures (7.5 vs. 0.6%), jaundice (50 vs. 16.9%), infection (12.5 vs. 3.8%), and birth asphyxia (23.8 vs. 5.6%). Early screen exposure within the first year of life was also significantly higher among cases (90 vs. 56.9%). Multivariate logistic regression analysis identified maternal antenatal stress, smoking exposure, neonatal jaundice, and early screen exposure as independent risk factors for ASD after adjusting for other variables (p < 0.05). While these findings provide important insights, further research is needed to confirm these associations and guide public health strategies aimed at reducing the prevalence of ASD in Bangladesh.