Adel Walha

Prenatal, perinatal and postnatal factors associated with autism spectrum disorder

OBJECTIVE To identify prenatal, perinatal and postnatal risk factors in children with autism spectrum disorder (ASD) by comparing them to their siblings without autistic disorders. METHOD The present study is cross sectional and comparative. It was conducted over a period of three months (July-September 2014). It included 101 children: 50 ASDs children diagnosed according to DSM-5 criteria and 51 unaffected siblings. The severity of ASD was assessed by the CARS. RESULTS Our study revealed a higher prevalence of prenatal, perinatal and postnatal factors in children with ASD in comparison with unaffected siblings. It showed also a significant association between perinatal and postnatal factors and ASD (respectively p=0.03 and p=0.042). In this group, perinatal factors were mainly as type of suffering acute fetal (26% of cases), long duration of delivery and prematurity (18% of cases for each factor), while postnatal factors were represented principally by respiratory infections (24%). As for parental factors, no correlation was found between advanced age of parents at the moment of the conception and ASD. Likewise, no correlation was observed between the severity of ASD and different factors. After logistic regression, the risk factors retained for autism in the final model were: male gender, prenatal urinary tract infection, acute fetal distress, difficult labor and respiratory infection. CONCLUSIONS The present survey confirms the high prevalence of prenatal, perinatal and postnatal factors in children with ASD and suggests the intervention of some of these factors (acute fetal distress and difficult labor, among others), as determinant variables for the genesis of ASD.

Profil psychologique des adolescents hémodialysés : étude transversale tunisienne

ObjectifEvaluer les manifestations depressives, anxieuses ainsi que l’estime de soi dans une population d’adolescents hemodialyses dans la region de Sfax (Tunisie).MethodologieNous avons procede a l’auto-passation chez 50 adolescents (10 hemodialyses et 40 temoins), de l’inventaire de depression CDI, l’inventaire d’anxiete STAI et le test de l’estime de soi de Cooper Smith SEI dans sa forme scolaire.ResultatsLes manifestations depressives et anxieuses ont ete significativement plus frequentes chez les patients hemodialyses (un score moyen de 25,1 contre 11,6 dans le CDI ; 52,4 contre 39,2 dans le STAI-etat et 52,8 contre 30 dans le STAI-trait) et l’estime de soi etait plus touchee sur le plan general et scolaire.ConclusionDevant la frequence des perturbations psychologiques chez les adolescents hemodialyses, un accompagnement psychologique devrait etre systematique afin de soulager la souffrance de ces jeunes et d’eviter l’installation de troubles psychiatriques durables.