Impact of socioeconomic factors and birth-related conditions on autism spectrum disorder, Down syndrome, and attention deficit/hyperactivity disorder

This study examined the association between socioeconomic factors and maternal birth-related variables in children diagnosed with Autism Spectrum Disorder (ASD), Down Syndrome (DS), and Attention Deficit/Hyperactivity Disorder (ADHD). A retrospective analysis was conducted using data from King Khalid University Hospital Riyadh between 2015 and 2024. The sample included 269 children: 185 with ASD, 51 with DS, and 33 with ADHD. Multivariable logistic regression was used to identify significant predictors. Maternal use of medications during pregnancy (excluding dietary supplements) was significantly associated with a higher likelihood of ASD (OR = 4.253, p = 0.012). Child age was also significant, with each additional year increasing ASD odds by about 5% (OR = 1.054, p = 0.040). Child birth order played a role, as first- or second-born children were less likely to be diagnosed with ASD compared to later-born children (OR = 0.660, p = 0.002). For DS, higher socioeconomic status index (SESi) was linked to a reduced risk, with each unit increase in SESi score, DS odds decreased significantly (OR = 0.578, p = 0.018). Maternal employment during pregnancy was associated with increased DS odds (OR = 1.535, p = 0.024). In contrast, maternal vitamin D supplementation was associated with reduced odds of DS (OR = 0.452, p = 0.028). Regarding ADHD, assisted conception was the only factor significant predictor. Children conceived through assisted reproductive methods had more than twice the likelihood of ADHD compared to those conceived naturally (OR = 2.401, p = 0.040). Maternal medication use during pregnancy was associated with increased ASD risk, while birth order and child age also played roles. For DS, higher socioeconomic status reduced risk, whereas maternal employment increased it and vitamin D supplementation was less associated with the disorder. Assisted conception was the only factor linked to increased ADHD risk. Overall, maternal, socioeconomic, and perinatal factors showed distinct associations across ASD, DS, and ADHD.