Advanced Maternal Age and Maternal Education Disparity in Children with Autism Spectrum Disorder
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Advanced Maternal Age and Maternal Education Disparity in Children with Autism Spectrum Disorder For‑Wey Lung1,2 · Tung‑Liang Chiang3 · Shio‑Jean Lin4 · Meng‑Chih Lee5,6,7,8 · Bih‑Ching Shu9
© Springer Science+Business Media, LLC, part of Springer Nature 2018
Abstract 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 lowerthan-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. Keywords Taiwan Birth Cohort Study · M-CHAT · Propensity score matching
* Bih‑Ching Shu [email protected] 1
Calo Psychiatric Center, Pingtung County, Taiwan
2
Graduate Institute of Medical Science, National Defense Medical Center, Taipei, Taiwan
3
College of Public Health, Institute of Health Policy and Management, National Taiwan University, Taipei, Taiwan
4
Genetic Counseling Center, Chi Mei Medical Center, Tainan, Taiwan
5
Department of Family Medicine, Taichung Hospital, Taichung, Taiwan
6
Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
7
Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
8
College of Health, National Taichung University of Science and Technology, Taichung, Taiwan
9
Department of Nursing and Institute of Allied Health Sciences, National Cheng Kung University, No. 1 Da‑Hsueh Rd., Tainan 701, Taiwan
Significance What is already known on this subject? Previous studies have shown inconsistent results in the association between advanced maternal age and autism spectrum disorder (ASD). The sociodemographic status of parents has been found to be associated with having children with ASD, however. What does this study add? The risk of a child being diagnosed with ASD was increased where the mother wa
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