Background:Autism spectrum disorder (ASD) is a severe psychiatric disorder of childhood comprised severe troubles in verbal, non verbal communication, language development, repetitive limited patterns of behaviors and obsessive resistance to small changes in familiar surrounding. Aim to assess role of epidemiological, clinical and psychiatric determinants as risk factors of ASD. Methods: A case control study was recruited on 72 ASD children attending psychiatric outpatient clinic and 72 healthy children. Their caregivers completed a questionnaire about risk factors for ASD. Then they underwent complete assessment of mental age using Stanford-Binet intelligence scale, childhood autism rating scale to outline severity of ASD in cases and exclude presence of autistic features in controls.Results:There is a statistically significant difference between both groups regarding mother,and father education, fathers’ age at conception, family history of psychiatric disorders, history of induction of ovulation, hypertension during pregnancy, folic acid supplementation during 1st trimester of pregnancy, use of anti D, history of postnatal hypoxia, admission to NICU and feeding type. A significant difference between them concerning reaction to others and delayed developmental milestones was found. About 63% and 58% had severe autism and mild to severe mental retardation respectivey. Paternal age, positive family history of psychiatric diseases, postnatal hypoxia significantly increased risk of ASD. Folic acid supplementation during 1st trimester of pregnancy significantly decreased risk.Conclusion: Family history of psychiatric disorders, Advanced fathers’ age at conception, postnatal hypoxia were significant risk factors. Folic acid supplementation during 1st trimester is a significant protector
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