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. 2014 Feb;44(2):394-404.
doi: 10.1007/s10803-013-1875-y.

Urbanicity and autism spectrum disorders

Marlene B Lauritsen  1 , Aske Astrup, Carsten Bøcker Pedersen, Carsten Obel, Diana E Schendel, Laura Schieve, Marshalyn Yeargin-Allsopp, Erik T Parner
Affiliations

Urbanicity and autism spectrum disorders

Marlene B Lauritsen et al. J Autism Dev Disord. 2014 Feb.

Abstract

The etiology of autism spectrum disorders (ASD) is for the majority of cases unknown and more studies of risk factors are needed. Geographic variation in ASD occurrence has been observed, and urban residence has been suggested to serve as a proxy for etiologic and identification factors in ASD. We examined the association between urbanicity level and ASD at birth and during childhood. The study used a Danish register-based cohort of more than 800,000 children of which nearly 4,000 children were diagnosed with ASD. We found a dose-response association with greater level of urbanicity and risk of ASD. This association was found for residence at birth as well as residence during childhood. Further, we found an increased risk of ASD in children who moved to a higher level of urbanicity after birth. Also, earlier age of ASD diagnosis in urban areas was observed. While we could not directly examine the specific reasons behind these associations, our results demonstrating particularly strong associations between ASD diagnosis and post-birth migration suggest the influence of identification-related factors such as access to services might have a substantive role on the ASD differentials we observed.

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Figures

Fig. 1
Fig. 1
Incidence rate ratio of Autism Spectrum Disorders (ASDs) according to the degree of urbanicity of residence at birth and age during follow-up. Vertical lines indicate 95 % confidence intervals. Adjustment has been made for age, sex, calendar period, maternal and paternal age, gestational age, birth weight, and parental psychiatric history at birth
Fig. 2
Fig. 2
Incidence rate ratio of Autism Spectrum Disorders (ASDs) according to the degree of urbanicity of residence at birth and birth year. Due to a low number of observed cases of ASD in the rural area in birth year 2003, 2004, and 2005, they were grouped into one category. Vertical lines indicate 95 % confidence intervals. Adjustment has been made for age, sex, calendar period, maternal and paternal age, gestational age, birth weight, and parental psychiatric history at birth
Fig. 3
Fig. 3
Incidence rate ratio of Autism Spectrum Disorders (ASDs) according to the degree of urbanicity of place of residence and calendar year of diagnosis. Due to a low number of observed cases of ASD in the rural area in birth year 1994, 1995, and 1996, they were grouped into one category. Vertical lines indicate 95 % confidence intervals. Adjustment has been made for age, sex, calendar period, maternal and paternal age, gestational age, birth weight, and parental psychiatric history at birth
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