Advanced Maternal Age and Maternal Education Disparity in Children with Autism Spectrum Disorder
Objective Previous studies have shown inconsistent results with regard to the association between advanced parental age and autism spectrum disorder (ASD). The sociodemographic status of parents has been found to be associated with children with ASD, however. Therefore, a pathway analysis was undertaken of the roles of maternal age and education in ASD diagnosis and community screening, in a national birth cohort database, using a propensity score matching (PSM) method. Method The 6- and 66-month Taiwan Birth Cohort Study dataset was used (N = 20,095). The PSM exact matching method was used to select 1700 families (ratio of 1:4 between ASD diagnosis and control) from the Taiwan Birth Cohort Study dataset. Results (1) The results from the complete dataset and the PSM exact matching dataset both show that the risk of a child being diagnosed with ASD was increased by the mother being over 40 years old. (2) Although more children of mothers with lower-than-average education were positive on screening, more children of mothers with higher-than-average education were also diagnosed with ASD. Conclusions for Practice Advanced maternal age had a higher association with the diagnosis of ASD, and maternal educational disparity was found between ASD clinical diagnosis and community screening. Community and primary medical care services should pay more attention to children of parents with lower education during ASD screening to prevent delayed diagnosis.
KeywordsTaiwan Birth Cohort Study M-CHAT Propensity score matching
This study was supported by the Bureau of Health Promotion [Grant Nos. DOH94-HP-1802, DOH95-HP-1802, DOH96-HP-1702, DOH99-HP-1702].
Compliance with Ethical Standards
Conflict of interest
All authors have no conflict of interest to disclose.
- Autism and Developmental Disabilities Monitoring Network Surveillance Year 2002 Principal Investigators, & Centers for Disease Control and Prevention (2007). Prevalence of autism spectrum disorders: Autism and Developmental Disabilities Monitoring Network, 14 sites, United States, 2002. MMWR Surveillance Summaries, 56, 12–28.Google Scholar
- Centers for Disease Control and Prevention. (2009). Prevalence of autism spectrum disorders—Autism and developmental disabilities monitoring network, United States, 2006. MMWR Surveillance Summaries, 58, 1–20.Google Scholar
- Developmental Disabilities Monitoring Network Surveillance Year 2010 Principal Investigators and Centers for Disease Control and Prevention. (2014). Prevalence of autism spectrum disorder among children aged 8 years—Autism and developmental disabilities monitoring network, 11 sites, United States, 2010. Morbidity and Mortality Weekly Report Surveillance Summaries, 63, 1–21.Google Scholar
- Hvidtjørn, D., Schieve, L., Schendel, D., Jacobsson, B., Svaerke, C., & Thorsen, P. (2009). Cerebral palsy, autism spectrum disorders, and developmental delay in children born after assisted conception: A systematic review and meta-analysis. Archives of Pediatrics & Adolescent Medicine, 163, 72–83.CrossRefGoogle Scholar
- Lung, F. W., Chiang, T. L., Lin, S. J., & Shu, B. C. (2016). Urban and Education Disparity for autism spectrum disorders in Taiwan Birth Cohort Study. Journal of Autism and Developmental Disorders, 47, 599–606 [Epub ahead of print].Google Scholar
- Lung, F. W., Shu, B. C., Chiang, T. L., & Lin, S. J. (2009). Twin-singleton influence on infant development: A national birth cohort study. Child: Care, Health and Development, 35, 409–418.Google Scholar
- Rai, D., Lewis, G., Lundberg, M., Araya, R., Svensson, A., Dalman, C., et al. (2012). Parental socioeconomic status and risk of offspring autism spectrum disorders in a Swedish population-based study. Journal of the American Academy of Child and Adolescent Psychiatry, 51, 467–476.CrossRefPubMedGoogle Scholar
- Runkel, P. (2012). Large samples: Too much of a good thing? http://blog.minitab.com/blog/statistics-and-quality-data-analysis/large-samples-too-much-of-a-good-thing. Accessed 4 July 2012.
- Sandin, S., Hultman, C. M., Kolevzon, A., Gross, R., MacCabe, J. H., & Reichenberg, A. (2012). Advancing maternal age is associated with increasing risk for autism: A review and meta-analysis. Journal of the American Academy of Child and Adolescent Psychiatry, 51, 477–486.CrossRefPubMedGoogle Scholar
- Thoemmes, F. (2012). Propensity score matching in SPSS. http://arxiv.org/abs/1201.6385. Accessed 24 July 2013.