Advanced Parental Age and Risk of Positive Autism Spectrum Disorders Screening

Introduction: Autism Spectrum Disorder (ASD) is a life‑ long neurodevelopmental disorder and significantly influences the quality of life in children. The screening of ASDin children aged between ۱۶‑۳۰ months to early detection and early intervention for better prognosis. Method: This cross‑sectional study was conducted in the southwest of Iran (Yasuj) with dominant Lore ethnicity in ۲۰۱۷. A total of ۱۵۰۴ mother‑ child pairs with children aged between ۱۶‑۳۰ months were selected through simple random sampling from the integrated national health system as the framework. ASD screening was implemented using the Modified checklist for autism in toddlers‑ revised, with follow‑up interview (M‑CHAT‑R/F). Demographic data such as sex of children, and parental age at their time of pregnancy were collected for all children.Data analyzez were done by SPSS۲۰ software using descriptive and analytic(logistic regression) statistics. Results: Mean age of toddlers was ۲۰.۲۶±۳.۷۴ months. ۷۵۵(۵۰.۲%) children were boysand ۷۴۹(۴۹.۸%) were girls. Mean age of children's mother and father was ۲۸.۰۱±۱.۳۷and ۳۲.۳±۱.۵۹ years, respectively. Risk of ASD was low, moderate and high in ۱۴۴۷ (۹۶.۲%),۵۴ (۳.۶%) and ۳ (۰.۲%) in screening, respectively. Follow-up evaluation was conducted for ۵۴ children with moderate risk. Out of ۵۴ children, ۱۳(۲۴%) screened positive infollow up interview and were referred to pediatric psychiatrist. Diagnosis of ASD was confirmed for ۱۰ of ۱۳(۷۷%) children. In high risk group, ۲ of ۳ (۶۶%) children, ASD diagnosis was confirmed by pediatric psychiatrist. In all, ۱۲ children (۷۵% of those assessed clinically) had met the criteria for ASD in the received feedback from pediatricpsychiatrist. The estimated rate of ASD prevalence was ۸۰ per ۱۰۰۰۰ (۱۲ out of ۱۵۰۴) or ۱ in ۱۲۵. Mother’s age ≥۳۵ (P-value=۰.۰۰۲, OR=۱۱.۶۵, CI۹۵%: ۲.۴۹‑۵۴.۳۵) and father’sage ≥۴۰ (P-Value=۰.۰۰۰۱, OR=۱۹.۶۴, CI۹۵%:۴.۸۹‑۷۸.۸۲) were predicting factors of ASD in toddlers aged ۱۶‑۳۰ months. Conclusions: In ۷۵% of screened positive toddlers in M-CHAT-R/F, ASD diagnosis was confirmed. So, widespread implementation of screening is recommended to reduce the age of ASD diagnosis. Given that, increasing the age of marriage in Iran and recent trend towards delayed childbearing; children born to older parents are at a higher risk for having ASD. So, increasing the public awareness is necessary.

کلیدواژه ها:

Autism Spectrum Disorder ، Mass Screening ، Parent.