Low Maternal Education, Gastrointestinal Problems and High Blood Lead Level: Risk Factors Related to the Severity of Autism Spectrum Disorder in Northeast China
Abstract Background: The prevalence of autism spectrum disorder (ASD) has increased rapidly in recent years. Environmental factors may play an important role in the pathogenesis of ASD. These factors may include socioeconomic factors, nutritional factors, heavy metal exposure, air pollution, etc. Our aim is to analyze possible environmental risk factors associated with the severity of ASD.Methods: All participating children were divided into two groups (mild and severe) according to the severity of their symptoms, as determined by their Childhood Autism Rating Scale (CARS) scores. The socioeconomic and demographic factors that may affect the severity of ASD and the nutritional factors that were correlated with ASD symptoms were included in the logistic regression to analyze whether they were risk factors that affected the severity of ASD.Results: Logistic regression showed that maternal education (P=0.038, OR=1.694, 95% CI: 1.029-2.789), gastrointestinal problems (P=0.045, OR=1.770, 95% CI: 1.012-3.097) and a high serum concentration of lead (P=0.001, OR=1.038, 95% CI: 1.016-1.060) were statistically significantly associated with ASD severity.Conclusion: Many environmental factors affect the severity of ASD. We concluded that maternal education, gastrointestinal problems and serum concentration of lead were risk factors that affected the severity of ASD in northeast China.