title: Prenatal, perinatal and postnatal factors associated with autism spectrum disorder.
abstract: OBJECTIVE
  To identify prenatal, perinatal and postnatal risk factors in children with autism spectrum disorder (ASD) by comparing them to their siblings without autistic disorders.
  
  
  METHODS
  The present study is cross sectional and comparative. It was conducted over a period of three months (July-September 2014). It included 101 children: 50 ASD's children diagnosed according to DSM-5 criteria and 51 unaffected siblings. The severity of ASD was assessed by the CARS.
  
  
  RESULTS
  Our study revealed a higher prevalence of prenatal, perinatal and postnatal factors in children with ASD in comparison with unaffected siblings. It showed also a significant association between perinatal and postnatal factors and ASD (respectively p=0.03 and p=0.042). In this group, perinatal factors were mainly as type of suffering acute fetal (26% of cases), long duration of delivery and prematurity (18% of cases for each factor), while postnatal factors were represented principally by respiratory infections (24%). As for parental factors, no correlation was found between advanced age of parents at the moment of the conception and ASD. Likewise, no correlation was observed between the severity of ASD and different factors. After logistic regression, the risk factors retained for autism in the final model were: male gender, prenatal urinary tract infection, acute fetal distress, difficult labor and respiratory infection.
  
  
  CONCLUSIONS
  The present survey confirms the high prevalence of prenatal, perinatal and postnatal factors in children with ASD and suggests the intervention of some of these factors (acute fetal distress and difficult labor, among others), as determinant variables for the genesis of ASD.
authors.affiliation: University of Sfax, Hédi Chaker Hospital, Department of Child and Adolescent Psychiatry, Sfax, Tunisia. Electronic address: hadjkacemimen@yahoo.fr.
authors.forename: Imen
authors.initials: I
authors.lastname: Hadjkacem
authors.affiliation: University of Sfax, Hédi Chaker Hospital, Department of Child and Adolescent Psychiatry, Sfax, Tunisia.
authors.forename: Héla
authors.initials: H
authors.lastname: Ayadi
authors.affiliation: University of Sfax, Hédi Chaker Hospital, Department of Child and Adolescent Psychiatry, Sfax, Tunisia.
authors.forename: Mariem
authors.initials: M
authors.lastname: Turki
authors.affiliation: University of Sfax, Hédi Chaker Hospital, Department of Community Medecine and Epidemiology, Sfax, Tunisia.
authors.forename: Sourour
authors.initials: S
authors.lastname: Yaich
authors.affiliation: University of Sfax, Hédi Chaker Hospital, Department of Child and Adolescent Psychiatry, Sfax, Tunisia.
authors.forename: Khaoula
authors.initials: K
authors.lastname: Khemekhem
authors.affiliation: University of Sfax, Hédi Chaker Hospital, Department of Child and Adolescent Psychiatry, Sfax, Tunisia.
authors.forename: Adel
authors.initials: A
authors.lastname: Walha
authors.affiliation: University of Sfax, Hédi Chaker Hospital, Department of Child and Adolescent Psychiatry, Sfax, Tunisia.
authors.forename: Leila
authors.initials: L
authors.lastname: Cherif
authors.affiliation: University of Sfax, Hédi Chaker Hospital, Department of Child and Adolescent Psychiatry, Sfax, Tunisia.
authors.forename: Yousr
authors.initials: Y
authors.lastname: Moalla
authors.affiliation: University of Sfax, Hédi Chaker Hospital, Department of Child and Adolescent Psychiatry, Sfax, Tunisia.
authors.forename: Farhat
authors.initials: F
authors.lastname: Ghribi
mesh_terms: D000367:Age Factors; D000067877:Autism Spectrum Disorder / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005316:Fetal Distress / Q000150:complications; D006801:Humans; D008297:Male; D007744:Obstetric Labor Complications; D010290:Parents; D011247:Pregnancy; D047928:Premature Birth; D012141:Respiratory Tract Infections / Q000150:complications; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D035781:Siblings; D011795:Surveys and Questionnaires; D014416:Tunisia
keywords: Autism spectrum disorder; Child; Criança; Fatores de risco; Perinatal; Postnatal; Prenatal; Pré-natal; Pós-natal; Risk factors; Transtorno do espectro do autismo