Perinatal and Neonatal Determinants of the Development and Severity of Autism Spectrum Disorder

Objective: Demonstrate the potential effects of breastfeeding, low birth weight, maternal age at the time of childbirth and birth order on the development and severity of Autism Spectrum Disorders (ASD). Methods: We analyzed data from the National Survey of Children’s Health (2012), for 19,957 children aged two to five years. Using multivariate logistic regression, we estimated the association between breastfeeding status, maternal age at the time of childbirth, birth weight and birth order and ASD, adjusting for age, gender, race and poverty level. In addition, we examined the influence of these factors on severity of ASD using ordinal logistic regression. Results: Children with low birth weight had twice the odds for ASD. Children with higher birth order had three times higher odds for ASD. Breastfed children had decreased odds for a severe form of ASD, as compared to those who were never breastfed or breastfed for less than six months. Children born to of mothers aged 25-30 years had higher odds for severe ASD, as compared to children born to mothers under 20 years at childbirth. Higher birth order children had a small (1%) decreased odds of severe ASD. Conclusion: Children with lower birth weight and higher birth order were more likely to have ASD. Children who were breastfed for six or more months had decreased risk for severe ASD. Children of mothers 25 to 30 years were more likely to have more severe form of ASD than children of younger mothers.