Gebelik ve Doğum Özelliklerinin Otizm Spektrum Bozukluğu ve Belirti Şiddeti ile İlişkisi

Year 2019, , 30 - 37, 20.03.2019

İrem Damla Çimen

https://doi.org/10.31832/smj.465688

Abstract

Amaç: Otizm Spektrum Bozukluğu nörogelişimsel bir bozukluk olup büyük oranda kalıtımsal olmakla birlikte çevresel faktörler de ilişkili bulunmuştur. Bu çalışmada gebelik süreci ve doğum özellikleri ile Otizm Spektrum Bozukluğu arasındaki ilişkinin incelenmesi ve Otizm Spektrum Bozukluğu belirti şiddeti ile bu süreçteki bazı faktörlerin ilişkisinin olup olmadığının değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Çalışmada araştırma grubu olarak Darıca Farabi Eğitim Araştırma Hastanesi çocuk psikiyatri polikliniğine başvuran, Otizm Spektrum Bozukluğu tanısı konulan 35 çocuk alınmış, kontrol grubu olarak ise bu çocuklar ile aynı cinsiyetteki, yaşı en yakın olan, herhangi bir ruhsal bozukluğu olmayan 35 kardeşi alınmıştır. Olguların gebelik süreci ve doğum özellikleri ile ilgili bilgiler sosyodemografik veri formu ile toplanmıştır. Otizm Spektrum Bozukluğu tanısı yapılan klinik görüşmelerde DSM 5 tanı kriterlerine göre konulmuş, belirti şiddeti Otizm Davranış Kontrol Listesi ile değerlendirilmiştir. Bulgular: Otizm Spektrum Bozukluğu olan olgularda plansız gebelik ve gebelikte stresli yaşam olayı yaşama oranı anlamlı düzeyde yüksek bulunmuştur. Otizm Davranış Kontrol Listesini ilişki kurma, beden ve nesne kullanımı, dil becerileri ve toplam puanlarının, plansız gebelik sonucu doğan Otizm Spektrum Bozukluğu olan olgularda belirgin düzeyde yüksek olduğu saptanmıştır. Sonuç: Otizm Spektrum Bozukluğu etyolojisinde çevresel etmenlerin etkilerinin incelenmesinin önemli olduğu, etyolojinin aydınlatılmasının bozukluğu önleme çalışmalarına katkı sağlayabileceği düşünülmektedir.

Keywords

Otizm spektrum bozukluğu, gestasyon, planlanmamış gebelik, doğum

The Correlation Between Pregnancy, Delivery Characteristics and Autism Spectrum Disorder and Symptomatic Severity

Abstract

Objective: Autism is a neurodevelopmental disorder. Although Autism is substantially hereditary, it has been associated with environmental factors as well. This study investigates the correlation between pregnancy period and delivery characteristics and Autism and to evaluate whether or not there is a correlation between the symptom severity and some factors in this period. Method: In the study, 35 children, who were admitted to the Child/Adolescent Psychiatry Clinic, diagnosed with Autism were taken as the study group, and their 35 siblings of the same gender with the closest age and without any mental disorder were taken as the control group. The diagnosis of Autism was made according to the DSM-5 Diagnostic Criteria in the clinic interviews held. Characteristics of delivery and birth were questioned by sociodemographic data form. And the symptom severity of Autism was assessed by using the Autism Behavior Checklist. Results: The rate of unplanned pregnancy and stressful life events during pregnancy was found to be significantly higher in the cases with Autism, and no correlation was found between Autism and other factors. The social relating, body and object use, language skills and total scores of the Autism Behavior Checklist were found to be significantly higher in children with Autism who were born as a result of unplanned pregnancy. Conclusion: There are few studies on Autism etiology in our country. It is important to investigate the effects of environmental factors in the etiology of Autism, and that elucidation of the etiology can contribute to prevention studies of the disorder

Keywords

Autism Spectrum Disorder, gestation, unplanned pregnancy, birth

References

• 1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM), 5th ed. Washington, DC: American Psychiatric Publishing; 2013.
• 2. Baxter AJ, Brugha TS, Erskine HE, Scheurer RW, Vos T, Scott JG. The epidemiology and global burden of autism spectrum disorders. Psychol Med 2015;45:601–613.
• 3. Christensen DL, Baio J, Braun KV, Bilder D, Charles J, Constantino JN, et al. Prevalence and characteristics of autism spectrum disorder among children aged 8 years—Autism and Developmental Disabilities Monitoring Network, 11 sites, United States, 2012. MMWR Surveill Summ 2016;65:1–23.
• 4. Werling DM, Geschwind DH. Sex differences in autism spectrum disorders. Curr Opin Neurol 2013:26;146–153.
• 5. Gurrieri F. Working up autism: the practical role of medical genetics. Am J Med Genet 2012;160C(2):104-110.
• 6. Bailey A, Le Couteur A, Gottesman I, Bolton P, Simonoff E, Yuzda E, et al. Autism as a strongly genetic disorder: Evidence from a British twin study. Psychol Med 1995;25(1):63-77.
• 7. Folstein S, Rutter M. Infantile autism: a genetic study of 21 twin pairs. J Child Psychol Psychiatry 1977;18(4):297-321.
• 8. Freitag CM. The genetics of autistic disorders and its clinical relevance: a review of the literature. Mol Psychiatry 2007;12(1):2.
• 9. Ritvo ER, Freeman BJ, Mason-Brothers A, Mo A, Ritvo AM. Concordance for the syndrome of autism in 40 pairs of afflicted twins. Am J Psychiatry 1985;142(1):74-77.
• 10. Steffenburg S, Gillberg C, Hellgren L, Andersson L, Gillberg IC, Jakobsson G, et al. A twin study of autism in Denmark, Finland, Iceland, Norway and Sweden. J Child Psychol Psychiatry 1989;30(3):405-416.
• 11. Dietert RR, Dietert JM, DeWitt JC. Environmental risk factors for autism. Emerging health threats journal 2011;4(1):7111.
• 12. Bilder D, Pinborough-Zimmerman J, Miller J, McMahon W. Prenatal, perinatal, and neonatal factors associated with autism spectrum disorders. Pediatrics 2009;123(5):1293-1300.
• 13. Glasson EJ, Bower C, Petterson B, de Klerk N, Chaney G, Hallmayer JF. Perinatal factors and the development of autism: a population study. Arch Gen Psychiatry 2004;61(6):618-627.
• 14. Hultman CM, Sparén P, Cnattingius S. Perinatal risk factors for infantile autism. Epidemiology 2002;13(4):417-423.
• 15. Juul-Dam N, Townsend J, Courchesne E. Prenatal, perinatal, and neonatal factors in autism, pervasive developmental disorder-not otherwise specified, and the general population. Pediatrics 2001;107(4):E63.
• 16. Kinney DK, Miller AM, Crowley DJ, Huang E, Gerber E. Autism prevalence following prenatal exposure to hurricanes and tropical storms in Louisiana. J Autism Dev Disord 2008;38(3):481-488.
• 17. Kinney DK, Munir KM, Crowley DJ, Miller AM. Prenatal stress and risk for autism. Neurosci Biobehav Rev 2008;32(8):1519-1532.
• 18. Larsson HJ, Eaton WW, Madsen KM, Vestergaard M, Olesen AV, Agerbo E, et al. Risk factors for autism: perinatal factors, parental psychiatric history, and socioeconomic status. Am J Epidemiol 2005;161(10):916-925.
• 19. Rodier PM, Ingram JL, Tisdale B, Nelson S, Romano J. Embryological origin for autism: Developmental anomalies of the cranial nerve motor nuclei. J Comp Neurol 1996;370(2):247–261.
• 20. Stromland K, Nordin V, Miller M, Akerstrom B, Gillberg C. Autism in thalidomide embryopathy: A population study. Dev Med Child Neurol 1994;36(4):351–356.
• 21. Hornig M, Bresnahan MA, Che X, Schultz AF, Ukaigwe JE, Eddy ML, et al. Prenatal fever and autism risk. Mol Psychiatry 2018;23(3):759-766.
• 22. Volk HE, Lurmann F, Penfold B, Hertz-Picciotto I, McConnell R. Traffic-Related Air Pollution, Particulate Matter, and Autism. JAMA Psychiatry 2013;70(1):71–77.
• 23. Grant WB, Soles CM. Epidemiologic evidence for supporting the role of maternal vitamin D deficiency as a risk factor for the development of infantile autism. Dermatoendocrinol 2009;1(4):223-228.
• 24. Boukhris T, Sheehy O, Mottron L, Bérard A. Antidepressant Use During Pregnancy and the Risk of Autism Spectrum Disorder in Children. JAMA Pediatr 2016;170(2):117-124.
• 25. Hamadé A, Salameh P, Medlej-Hashim M, Hajj-Moussa E, Saadallah-Zeidan N, Rizk F. Autism in children and correlates in Lebanon: a pilot case-control study. J Res Health Sci 2013;13(2):119–124.
• 26. Idring S, Magnusson C, Lundberg M, Ek M, Rai D, Svensson AC, et al. Parental age and the risk of autism spectrum disorders: findings from a Swedish population-based cohort. Int J Epidemiol 2014;43(1):107-115.
• 27. Walker CK, Krakowiak P, Baker A, Hansen RL, Ozonoff S, Hertz-Picciotto I. Preeclampsia, placental insufficiency, and autism spectrum disorder or developmental delay. JAMA Pediatr 2015;169(2):154-162.
• 28. Burstyn I, Wang X, Yasui Y, Sithole F, Zwaigenbaum L. Autism spectrum disorders and fetal hypoxia in a population-based cohort: accounting for missing exposures via Estimation-Maximization algorithm. BMC Med Res Methodol 2011;11(1):2.
• 29. Chaste P, Leboyer M. Autism risk factors: genes, environment, and gene-environment interactions. Dialogues Clin Neurosci 2012;14(3):281.
• 30. Zhang X, Lv CC, Tian J, Miao RJ, Xi W, Hertz-Picciotto I, et al. Prenatal and perinatal risk factors for autism in China. J Autism Dev Disord 2010;40(11):1311-1321.
• 31. Krug D, Arick J, Almond P. Autism Behavior Checklist – ABC. In: Krug DA, Arick J, Almond P. Autism Screening Instrument for Educational Planning- ASIEP-2. Austin, Texas: PRO-ED; 1993.
• 32. Yılmaz-Irmak T, Tekinsav-Sütçü S, Aydın A, Sorias O. Otizm Davranış Kontrol Listesinin (ABC) geçerlilik ve güvenirliliğinin incelenmesi. Çocuk ve Gençlik Ruh Sağlığı Dergisi 2007;14(1):13-23.
• 33. O’donnell K, O’connor TG, Glover V. Prenatal stress and neurodevelopment of the child: focus on the HPA axis and role of the placenta. Dev Neurosci 2009;31(4):285-292.
• 34. Ward AJ. A comparison and analysis of the presence of family problems during pregnancy of mothers of “autistic” children and mothers of normal children. Child Psych Hum Dev 1990;20(4):279-288.
• 35. Beversdorf DQ, Manning SE, Hillier A, Anderson SL, Nordgren RE, Walters SE, et al. Timing of prenatal stressors and autism. J Autism Dev Disord 2005;35(4):471-478.
• 36. Polat Çorumlu E, Ulupınar E. Neurobiological effects of prenatal stress exposure. Osmangazi journal of medicine 2016;38:89-98.
• 37. Angelidou A, Asadi S, Alysandratos KD, Karagkouni A, Kourembanas S, Theoharides TC. Perinatal stress, brain inflammation and risk of autism. BMC Pediatr 2012;12:89.
• 38. Barros VG, Berger MA, Martijena ID, Sarchi MI, Perez AA, Molina VA, et al. Early adoption modifies the effects of prenatal stress on dopamine and glutamate receptors in adult rat brain. Journal of neuroscience research 2004;76(4):488-496.
• 39. Huppert-Kessler CJ, Poeschl J, Hertel R, Unsicker K, Schenkel J. Effects of a new postnatal stress model on monoaminergic neurotransmitters in rat brains. Brain and development 2012;34(4):274-279.
• 40. Herman JP, Cullinan WE. Neurocircuitry of stress: central control of the hypothalamo pituitary-adrenocortical axis. Trends Neurosci 1997;20:78-84.
• 41. Barbazanges A, Piazza PV, Le Moal M, Maccari S. Maternal glucocorticoid secretion mediates long-term effects of prenatal stress. Journal of Neuroscience 1996;16(12):3943-3949.
• 42. Schanen NC. Epigenetics of autism spectrum disorders. Hum Mol Genet 2006;15:R138-R50.
• 43. Coe CL, Lubach GR, Karaszewski JW. Prenatal stress and immune recognition of self and nonself in the primate neonate. Biol Neonate 1999;76(5):301-310.
• 44. Grabrucker AM. Environmental Factors in Autism. Front Psychiatry 2012;3:118.
• 45. Rai D, Golding J, Magnusson C, Steer C, Lewis G, Dalman C. Prenatal and early life exposure to stressful life events and risk of autism spectrum disorders: population-based studies in Sweden and England. PloS one 2012;7(6):e38893.
• 46. Bunevicius R, Kusminskas L, Bunevicius A, Nadisauskiene RJ, Jureniene K, Pop VJ. Psychosocial risk factors for depression during pregnancy. Acta Obstet Gynecol Scand 2009;88:599-605.
• 47. Yücel P, Çayır Y, Yücel M. Birinci trimester gebelerde depresyon ve anksiyete bozukluğu. J Clin Psy 2013;16:83-87.
• 48. Venker C, McDuffie A, Ellis Weismer S, Abbeduto L. Increasing verbal responsiveness in parents of children with autism: A pilot study. Autism 2011;16(6):568-585.
• 49. Siller M, Sigman M. The behaviors of parents of children with autism predict the subsequent development of their children’s communication. J Autism Dev Disord 2002;32:77–89.
• 50. Özbaran B. Do environmental factors have influence on autism spectrum disorder? The journal of pediatric research 2014;1(4):170-173.