Perinatal and Background Risk Factors for Children with Autism Spectrum Disorder in Indonesia

Background: Indonesia has experienced an increased number of children with autism spectrum disorder (ASD). One of the challenges that Indonesia currently faces is how to reduce the perinatal and risk factors related with the incidence of autism. This study aimed to identify the perinatal and risk factors contributing to ASD.

Method: This research was a case control study involving 52 children with ASD in the case group and 201 normal children in the control group in Banyumas district, Province of Central Java, Indonesia. Data collection used independently completed questionnaires, concerning perinatal factors such as maternal age at birthing, gestational age, labor method, fetus presentation in labor, and history of complications during labor.

Results: Stepwise logistic regression analysis indicated a higher risk of preterm gestational age among children in the ASD group with p=0.019 and OR:5.883. Abnormal delivery method such as caesarean delivery or vacuum extraction also had association with the ASD group (p=0.001; OR=0.303). Abnormal fetus presentation during labor increased the risk of ASD (p=0.004; OR:6.908). Mother with complication during labor such as difficult labor, preeclampsia, and fetal distress correlated with ASD (p=0,.021; OR:2.101). Multivariate analysis also showed complications during labor became a risk factor for ASD (OR: 2.142 (1.904-4.196). There was no correlation between maternal age below 20 years (p=0.332; OR=1.871) or 31-40 years (p=0.115; OR=2.868) with ASD.

Conclusion: Labor method, fetus presentation, and complication during labor were significantly related with ASD.