Prenatal, Perinatal, Postnatal risk factors, and excess screen time in autism spectrum disorder

Güneş H., Tanıdır C., Doktur H., Yılmaz S., Yıldız D., Özbek F., ...More

Pediatrics International, vol.65, no.1, 2023 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 65 Issue: 1
  • Publication Date: 2023
  • Doi Number: 10.1111/ped.15383
  • Journal Name: Pediatrics International
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, CINAHL, EMBASE, MEDLINE, Veterinary Science Database
  • Keywords: autism, perinatal, postnatal, prenatal, screen exposure
  • Istanbul Gelisim University Affiliated: Yes


Background: The aim of this study is to investigate prenatal, perinatal, and postnatal factors, screen time in a group of patients with ASD and age and sex-matched clinical controls to evaluate risk factors specific to ASD. Methods: The study included 211 ASD patients (177 boys, 34 girls; mean age 44.3±13.0 months) and 241 (190 boys, 51 girls; mean age 44.6±14.1 months) age and sex group matched clinical controls. Non-ASD diagnoses were expressive language disorder (n=135, 56.0 %), intellectual disability (n=15, 6.2%), attention deficit-hyperactivity disorder (n=6, 2.4%), oppositional disorder (n=6, 2.4%), and other behavioral or emotional problems (no diagnosis) (n=79, 32.8%). A sociodemographic data form was used to collect data regarding pre-, peri-, and postnatal factors and total daily screen exposure. Results: According to our findings, maternal severe psychological stress and depression during pregnancy, and maternal postpartum depression were more frequent in the ASD group (p=0.005, p=0.035, and p=0.001 respectively). There was a statistically significant difference between groups with regards to maternal any medication use during pregnancy (p=0.004). The mean duration of daily screen exposure was higher in the ASD group (9.90±5.10 hours) compared to non-ASD children (4.46±3.40 hours) (p<0.001). A ROC curve showed that 8.5 hours and above total daily screen exposure (AUC = 0.808 [95%CI, 0.769-0.848], p<000; 55% sensitivity, 90.5% specificity) is likely to be associated with increased risk for ASD. Conclusion: Our study suggests that prenatal maternal psychological stress, prenatal and postpartum depression, and excess exposure to screen might be related to an increased risk for ASD.