Burden of Co-occurring Conditions and Perinatal Predictors of Epilepsy in Autism Spectrum Disorder: A Cross-Sectional Study of 1015 Children From Northwestern Mexico.

内容摘要

Children with ASD frequently present with multiple co-occurring conditions affecting clinical management and quality of life. Systematic data on the burden of co-occurring conditions and perinatal risk factors remain scarce in Latin America. This study aimed to characterize the co-occurring condition profile, burden, and perinatal predictors in a large ASD cohort from Northwestern Mexico, examining their relationships with ASD severity and intellectual functioning. This retrospective, cross-sectional study reviewed 1015 children with ASD (January 2022-January 2024) at the Sinaloa Autism Center, Culiacán, Mexico. ASD was diagnosed per DSM-5 by a board-certified pediatric neurologist. Severity was assessed using the CARS-2; intellectual functioning was assessed using the WISC-IV in 508 patients (≥ 6 years). Co-occurring condition burden was scored across seven domains. Three binary logistic regression models were constructed for epilepsy, ADHD, and sleep disorders. Of 1,015 children, 83.3% were male (ratio 4.9:1). Median co-occurring condition burden was 3 per patient (IQR 2-4); 58.3% had ≥ 3 simultaneous co-occurring conditions. Language disorder was most prevalent (91.2%), followed by feeding/gastrointestinal disorders (69.8%), sleep disorders (63.2%), ADHD (33.8%), anxiety (12.9%), epilepsy (8.9%), and depression (3.0%). Perinatal asphyxia was the only independent predictor of epilepsy (adjusted OR = 2.02; 95% CI: 1.14-3.57; p = 0.016). ADHD was inversely associated with ASD severity (OR = 0.71; p = 0.015) and positively with higher intellectual functioning (p = 0.016). This largest ASD cohort from Northwestern Mexico reveals an extremely high multimorbidity burden. Perinatal asphyxia independently predicts epilepsy in ASD, representing a concrete, preventable target. Systematic multidisciplinary co-occurring condition screening at ASD diagnosis is strongly recommended across all levels of care in Mexico.