The Journal of Pediatrics
Volume 154, Issue 3 , Pages 345-350.e1, March 2009

Increased Risks of Congenital, Neurologic, and Endocrine Disorders Associated with Autism in Preschool Children: Cognitive Ability Differences

  • Chuan-Yu Chen, PhD

      Affiliations

    • Division of Mental Health and Substance Abuse Research, National Health Research Institutes, Zhunan, Taiwan
    • National Yang-Ming University, Institute of Public Health and Department of Social Medicine, Taipei, Taiwan
    • Corresponding Author InformationReprint requests: Chuan-Yu Chen, PhD, National Health Research Institutes, Division of Mental Health and Substance Abuse Research, 35 Keyan Road, Zhunan, Miaoli County 350, Taiwan
    • ,
  • Kuang-Hung Chen, MSc

      Affiliations

    • Division of Mental Health and Substance Abuse Research, National Health Research Institutes, Zhunan, Taiwan
    • ,
  • Chieh-Yu Liu, PhD

      Affiliations

    • Department of Nursing, National Taipei College of Nursing, Taipei, Taiwan
    • ,
  • Su-Ling Huang, MSc

      Affiliations

    • Division of Mental Health and Substance Abuse Research, National Health Research Institutes, Zhunan, Taiwan
    • ,
  • Keh-Ming Lin, MD, MPH

      Affiliations

    • Division of Mental Health and Substance Abuse Research, National Health Research Institutes, Zhunan, Taiwan

Received 19 February 2008; received in revised form 4 June 2008; accepted 24 September 2008. published online 25 November 2008.

Objective

To investigate the increased risk of congenital, neurologic, and endocrine disorders in autistic preschool children and to probe possible cognitive impairment-associated variation in such risks.

Study design

Using a population-based longitudinal study, a total of 3440 autistic children born in 1997-1999 and 33391 age- and residential urbanicity–matched control subjects were identified from the National Health Insurance Research Database in Taiwan. Conditional logistic analyses were performed to estimate the strength of association stratified by the presence of cognitive impairment.

Results

Autistic children were found to have greatly elevated risks of congenital anomalies (eg, tuberous sclerosis: adjusted odds ratio [aOR] = 34∼61) and neurologic disorders (eg, epilepsy: aOR = 5∼13) compared with their matched nonautistic peers. The increased risk of medical diseases for mentally retarded autism were approximately 1.6 to 9 times greater than those for isolated autism.

Conclusions

The observed cognitive impairment-related variation in the increased risk of congenital, neurological, and endocrine disorders with autism may provide some clinical and etiologic implications that warrant investigation in the future.

Abbreviations: aOR, Adjusted odds ratio, ICD, International Classification of Diseases, NHIP, National Health Insurance Program

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 This work is completely supported by the National Health Research Institutes, which had no involvement in the study design, data collection, analysis, and interpretation, report writing, or the decision to submit the paper for publication. The authors declare no conflicts of interest.

PII: S0022-3476(08)00817-2

doi:10.1016/j.jpeds.2008.09.043

The Journal of Pediatrics
Volume 154, Issue 3 , Pages 345-350.e1, March 2009

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