Severe autism spectrum disorders common among children with immigrant parents in Finland
Introduction An increase in the proportion of visits and referrals of patients with an immigrant background has been noted at the New Children’s Hospital Day Centre, a centre specializing in autism spectrum disorders (ASD) and other severe developmental disorders.
Methods We studied the records of the 455 3–6-year-old patients treated at the day centre, and compared the background information and risk factors of the patients to the population of the same age in the whole hospital district (Helsinki and Uusimaa, HUS).
Results A total of 306 patients had ASD and 233 of them had also global developmental delay (GD). Of those with GD, 209 (89.7%) were born in Finland, but only in 7.3% of cases were both parents of Finnish origin, while 11.6% had a Finnish mother. The immigrant parents originated from 75 countries. Children of mothers from Africa and the Middle East were at approximately a 50-fold risk of severe ASD compared to children with Finnish origin mothers. Compared to the whole same-aged population, children with both ASD and an immigrant background were more frequently boys, firstborns and born late in the year, with low birth weight, delivered using C-section or vacuum extraction. Altogether 27.9% of their mothers had a history of gestational diabetes mellitus.
Conclusions The proportion of severe ASD patients with immigrant parents is high. It is crucial to pay special attention to the health and maternal care of immigrant women. A vitamin D deficiency during early pregnancy might contribute to this phenomenon and requires further research.
Mirjami Jolma, Mikko Koivu-Jolma, Anne Sarajuuri, Raija Vanhala
Mirjami Jolma
M.D., M.Soc.Sc., Specialist in Paediatric Neurology, Department Head
Päijät-Häme Central Hospital / Paediatric Neurology, and University of Helsinki
Mikko Koivu-Jolma
BSc
University of Helsinki
Anne Sarajuuri
M.D., PhD., Specialist in Pediatric Neurology, Deputy Chief Physician
Helsinki University Central Hospital, New Childrens' Hospital
Raija Vanhala
Docent, Adjunct Professor
University of Helsinki