Transtorno do Espectro do Autismo, eventos adversos no parto e aleitamento materno: um estudo de caso controle

Abstract

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder whose signs and symptoms manifest early in affected individuals. The number of ASD cases is on the rise and affected families are subject to a great socioeconomic impact. The identification of factors associated with ASD, especially those that are susceptible to modification, is important because it makes it possible to create public health policies aimed at preventing ASD. This study aimed to evaluate the association between ASD and the occurrence of adverse events at birth and breastfeeding in children/adolescents in northern Minas Gerais, Brazil. A case control study consisting of 248 binomials mothers/individuals with diagnosis of ASD (case group) and 886 children/adolescents with neurotypical development (control group) was developed. A semi-structured questionnaire was used as a data collection tool. To identify the factors associated with TEA, the chi-square test was used in the bivariate analysis and logistic regression model for performing multiple analysis. Odds ratio (OR) gross and adjusted were used to estimate the magnitude of associations. Two articles were produced: Article 1 - Association between autism spectrum disorder and childbirth events: the case-control study, which aimed to evaluate the association between adverse events of childbirth and the TEA in children and adolescents; Article 2 - Breastfeeding and autism spectrum disorder: case control study, which aimed to evaluate the association between breastfeeding and the TEA. Among the variables related to the adverse events of childbirth, the following presented an association with the ASD, at a level of 0.05, in the adjusted analysis: emergency cesarean section (OR=2.38; 95%CI=1.61-3.51) and presence of meconium in the amniotic fluid (OR=1.67; 95%CI=1.06-2.65). It was also found that children and adolescents with ASD were more likely to have been exposed to two or more adverse events at delivery (OR=1.59; 95%CI=1.01-2.51). When the association of ASD with breastfeeding was evaluated, in the three adjusted models the absence of breastfeeding showed a positive and significant association with the disorder (Model 1: OR=2.0, 95%CI=1.1-3.8; Model 2: OR=2.1, 95%CI=1.1-4.2; Model 3: OR=2.1, 95%CI=1.1-4.1). Given the growing importance of ASD, early identification of potentially modifiable risk factors, such as delivery events and the presence of breastfeeding, is an important clinical and public health tool and can be useful in creating measures for intervention and health promotion.