ASSOCIATION OF PERINATAL RISK FACTORS WITH AUTISM SPECTRUM DISORDER: A RETROSPECTIVE STUDY AT TERTIARY CARE CENTRE, MUMBAI

Background: Autism spectrum disorder (ASD) is a complex neurodevelopmental condition, which is characterized by cognitive, behavioral, and social dysfunction. Their onset occurs in early childhood and during this period, there are various factors associated with autism risk. Hence,the present study was undertaken to determine the prevalence of various perinatal risk factors and its association with ASD in children. Methods: This was a retrospective study, included 200 cases of ASD over 5 years registered in pediatric neurodevelopment clinic at TN Medical College and BYL Nair Hospital, Mumbai. Study population divided in two groups- cases of ASD with perinatal risk factor and cases of ASD without perinatal risk factor. The prevalence of various perinatal risk factors in children with different grades of ASD calculated. Results: Based on ISAA score 149(74.5%) cases had mild autism and 51(25.5%) cases had moderate autism. The prevalence of various perinatal risk factors in children with different grades of ASD was found to be 79.5%(159/200). Pregnancy induced hypertension, bad obstetric history in mother were signicant risk factor for ASD. Lower segment caesarian section as mode of delivery was risk factor found to be associated more with mild form of autism, but statistically signicant association was found with vacuum delivery. We observed prematurity, low birth weight (LBW) and neonatal seizures as signicant risk factor, which may have contribution towards pathogenesis of ASD. Conclusion: The awareness between pediatrician and obstetrician about association of perinatal risk factors and ASD will denitely add to prevention and timely intervention of high risk patients.

Perinatal Risk Factors and ADHD in Children and Adolescents: A Hierarchical Structure of Disorder Predictors

Objective: The aim of the study was to hierarchically assess the predictive power of low and high birth weight, pre-term and post-term birth, and low Apgar score as the risk factors for ADHD. Method: The data of 132 boys diagnosed with ADHD and 146 boys from control group, aged 6 to 18 years, have been analyzed. The boys were categorized according to term of birth, birth weight, and Apgar score. CART method (Classification and Regression Trees) was used for assessment of the relationship between perinatal factors and the risk of ADHD. Results: Low Apgar score (21.97% vs. 13.01%) and post-term birth (12.12% vs. 0.68%) were more frequent in the sample than in the control group. CART method additionally indicated low birth weight as associated with the risk of ADHD. Among analyzed risk factors, Apgar score had the highest predictive value. Conclusion: The decreased Apgar score is the most important perinatal risk factor of ADHD. Research results also indicated a high significance of post-term birth in predicting the disorder.

NOISE LEVELS IN INFANT INCUBATORS (ADVERSE EFFECTS?)

Certain environmental factors in neonatal intensive care have attracted large interest and have been studied thoroughly. However, less attention has been paid to the noise level inside infant incubators. The present study of four different types of incubators revealed high sound levels of 70 to 80 dB sound pressure level (SPL) at 125 Hz. Some infants are nursed in incubators for weeks or months and thereby exposed to these noise levels for an undue period of time. It is suggested that the high noise levels in infant incubators should be considered a perinatal risk factor with regard to later hearing impairment. It deserves more attention as hitherto, especially with consideration to the construction of incubators, but also in follow-up studies of long-term sequelae after an abnormal perinatal period.