Risk and Protection Factors of Comorbidities in Pediatric Cohort with ASD: Elena Cohort

Background: Medical conditions are more prevalent in youth with ASD than in the general population. These conditions are often related to the occurrence of aberrant behaviors, under-diagnosed and not taken into account for prevention.

Objectives: This study aimed to better estimate the prevalence and risk factors of comorbidities in ASD among children and adolescents.

Methods:  ELENA cohort is a French prospective and multicenter study. Participants aged between 2 and 16 years, have a diagnosis of ASD formally established by multidisciplinary assessment according to ADOS, ADI and international criteria (ICD10/DSMV). Medical conditions are collected using an exhaustive and standardized parental questionnaire adapted from NIMH* and psychiatric symptoms using the CBCL.

Results: Our data focused on a subset of 400 participants. The most frequent prenatal medical conditions during are: maternal infection treated by antibiotics (17.6%), high maternal blood pressure (8%) and drug exposure (40%). The most frequent post-natal medical conditions are: gastrointestinal diseases (31.8 %), dermatological diseases (29.9%) and neurological disorders (29.5%). About 38% of children are under medical treatment. According to the CBCL6-18 years, 66% of participants exhibit psychiatric internalizing symptoms and 42% of externalizing problems: 51% of anxiety problems, 49% of affective problems, 19% of oppositional defiant problems, 14% of hyperactivity and attention deficit problems, 7% of conduct problems and 5% of somatic problems. The links between the occurrence of these conditions and several clinical or psychosocial variables are examined in order to find risk or protection factors.

Conclusions: These results confirmed the high frequency of medical conditions and comorbid symptoms in pediatric population with an ASD. These comorbidities are linked with clinical and psychosocial and they have to be better identified and early treated to prevent their negative impact on outcome trajectories. This will contribute to improve the quality of life of the whole family.