Pre-, Peri-, and Neonatal Factors Associated with Autism Spectrum Disorder: Results of a Lebanese Case-control Study

Aline Hajj; Souheil Hallit; Rouba El-Khatib; Sandra Abi Haidar; Fabienne Hajj Moussa Lteif; Layal Hajj; Maguy Moudawar; Lydia Rabbaa Khabbaz

Pre-, Peri-, and Neonatal Factors Associated with Autism Spectrum Disorder: Results of a Lebanese Case-control Study

Innov Clin Neurosci. 2022 Jul-Sep;19(7-9):22-27.

Authors

Aline Hajj^{1

2}, Souheil Hallit³, Rouba El-Khatib¹, Sandra Abi Haidar¹, Fabienne Hajj Moussa Lteif², Layal Hajj⁴, Maguy Moudawar⁴, Lydia Rabbaa Khabbaz^{1

2}

Affiliations

¹ Drs. A. Hajj, El-Khatib, Abi Haidar, and Rabbaa Khabbaz are with the Faculty of Pharmacy, Saint-Joseph University in Beirut, Lebanon.
² Drs. A. Hajj and Rabbaa Khabbaz and Ms. Hajj Moussa Lteif are with Laboratoire de Pharmacologie, Pharmacie Clinique et Contrôle de Qualité des Médicaments, Saint-Joseph University in Beirut, Lebanon.
³ Dr. Hallit is with the Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK) in Jounieh, Lebanon; Research Department, Psychiatric Hospital of the Cross in Jal Eddib, Lebanon; and Psychology Department, College of Humanities, Effat University in Jeddah, Saudi Arabia.
⁴ Ms. L. Hajj and Ms. Moudawar are with SESOBEL in Ain El Rihani, Lebanon.

PMID: 36204169
PMCID: PMC9507149

Abstract

Objective: The prevalence of autism spectrum disorder (ASD) in Lebanon is higher than what is reported by the World Health Organization (WHO), leading to the thought that the Lebanese population has some specific risk factors for ASD. Therefore, it is important to conduct more robust studies on this population. We conducted this study to identify pre-, peri-, and neonatal risk factors for ASD. Our ultimate goal was to detect and change some modifiable risk factors, thus reducing the incidence of ASD.

Design: A case-control study was conducted using a random proportional sample of Lebanese children with ASD to explore whether risk factors, such as family history, pregnancy (including all medication and substances taken during pregnancy and infection history), gestational age, delivery, birth milestones, and the neonate's condition at birth could be associated with a higher prevalence of ASD. The local ethical committee approved the study (USJ-2016-91), and all parents gave their written consent.

Results: A total of 66 children with ASD and 66 controls were included. The results of the multivariable analysis showed that a higher gestational weight gain (adjusted odds ratio [ORa]: 1.11) was significantly associated with higher odds of autism, whereas female sex (ORa: 0.13) and higher number of weeks of gestation (ORa: 0.76) were significantly associated with lower odds of autism.

Conclusion: Such results are of great relevance, since many of the identified factors herein could be avoidable or modifiable, suggesting the need for implementing timely and appropriate public health strategies for disease prevention in pregnant women that could reduce ASD.

Keywords: Autism spectrum disorder; case-control study; gestational weight gain; pregnancy; risk factors.