Prenatal and perinatal risk subtypes associated with autism and behavioural profiles in Kenya and South Africa
Document Type
Article
Department
Institute for Human Development
Abstract
Autism is a neurodevelopmental condition that has been reported to affect 1 in 100 children. Over 90% of children under the age of 5 years with neurodevelopmental disabilities (NDDs), such as autism, live in lower and middle-income countries. However, the majority of autism research is carried out in high-income countries. Prenatal and perinatal risk factors may give more insight into patterns of factors that may be shared or shared aetiology of autism and other neurodevelopmental conditions. Multipleprenatal risk factors have been put forward as being associated with an elevated risk of autism and other NDDs, endorsing the hypothesis that environmental and genetic factors contribute to autism. Pre-and-peri-natal events such as preeclampsia, alcohol exposure, prolonged labour, birth asphyxia, preterm birth and low birth weight are common in Africa. These environmental risk factors potentially increase the risk for autism; however, little is known from the Geographical South regarding unique risk factor clusters and their association with the clinical presentation of autism and co-occurring behavioural subtypes. The aim of this study is to measure how environmental risk factor variables and de novo variant burden interact to generate specific neurodevelopmental profiles, influencing autistic traits, ADHD traits, social communication traits, and internalising and externalising behaviours. This study is nested within a larger case-control study referred to as the NeuroDev study, which aims to characterise the genetic and phenotypic architecture of neurodevelopmental conditions such as autism. Participants in this study included 273 children with autism and 248 children with other NDDs. Pre-and-peri-natal variables and socio-demographic factors were collected using a bespoke neuromedical questionnaire, an alcohol exposure questionnaire; asset index questionnaires that measure socio-economic status, and a demographics questionnaire. Genetic variants associated with an NDD diagnosis are also available. We will first describe the frequencies of the pre-and-peri-natal factors of interest between autistic children and children with other NDDs. We will thereafter use latent profile analysis to delineate the clusters of risk factors in the underlying data from Kenya and South Africa. With these emerging risk factor subtypes, we will test whether diagnostic categories of NDDs map onto these subtypes and explore the concordance between risk factor profiles and autism/NDD phenotypes. We will use the autism and neurodevelopmental symptom sub-domain scores and the total scores of behavioural tools such as the Developmental Diagnostic Dimensional Interview (3Di), the Child Behaviour Checklist (CBCL), Swanson Nolan and Pelham (SNAP)-ADHD questionnaire, and the Social Communications Disorder Checklist (SCDC). We hypothesise that there may be unique clusters of pre-and-peri-natal events that are associated with specific autism and co-occurring behavioural phenotypes with a higher frequency of prenatal/postnatal events associated with more severe autistic and neurodevelopmental phenotypes. We will present the results of a study based on the African continent on environmental risk factors and patterns associated with autism and neurodevelopmental phenotypes. These subtypes could have implications for the nosology of NDD classification and possible utility in developmental monitoring.
Publication (Name of Journal)
European Neuropsychopharmacology
DOI
https://doi.org/10.1016/j.euroneuro.2024.08.044
Recommended Citation
Kipkemo, P.,
Vrije, J. S.,
Melly, B.,
O'Heir, E.,
Murugasen, S.,
Eastman, E.,
Kombe, M.,
Kipkoech, C.,
Bryant, S.,
Abubakar, A.
(2024). Prenatal and perinatal risk subtypes associated with autism and behavioural profiles in Kenya and South Africa. European Neuropsychopharmacology, 87(1), 15.
Available at:
https://ecommons.aku.edu/eastafrica_ihd/217
