Background: Autism spectrum disorder (ASD) is a complex neurodevelopmental condition influenced by a range of genetic, prenatal, and socioeconomic factors. This study aimed to examine the association of neonatal jaundice and other potential factors with ASD.
Methods: A frequency-matched case–control study was conducted from 1 January to 30 June 2024 at Al-Batool Teaching Hospital in Diyala Province, Iraq. The sample included 113 children with confirmed ASD and 113 age-frequency–matched controls. Sociodemographic and clinical data were collected through structured parent interviews and review of medical records. Bivariate analyses and binary logistic regression were performed to assess associations and identify factors
independently associated with ASD.
Results: Data from 226 children aged 24–60 months were included in the final analysis. The proportion of males was significantly higher among children with ASD than among controls (67.3% vs. 52.2%, p = 0.026). Children with ASD were also more likely to reside in urban areas and to have a family history of ASD (p = 0.005 and p < 0.001, respectively). A history of neonatal jaundice was more common in the ASD group than in the control group (72.6% vs. 46.9%, p < 0.001). In multivariable logistic regression analysis, family history of ASD (OR = 5.37, 95% CI: 1.99–14.46), neonatal jaundice (OR = 2.85, 95% CI: 1.54–5.29), male sex (OR = 2.16, 95% CI: 1.17–3.98), and urban residence (OR = 1.91, 95% CI: 1.06–3.44) were significantly independently associated with ASD.
Conclusion: Family history of ASD, neonatal jaundice, male sex, and urban residence were independently associated with ASD in children. These findings support a possible role for familial and early-life environmental factors in ASD.