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Published on: July 11, 2025
[Autism and prematurity: state of the art]
L Ouss-Ryngaert1, L Alvarez, A Boissel
1Service de neuropédiatrie, hôpital Necker, 149, rue de Sèvres, 75015 Paris, France. lisa.ouss@wanadoo.fr
Insights
Very low birth weight children have a significantly higher rate of autism spectrum disorder (ASD). This review examines research on ASD in premature infants, highlighting key findings and potential causes.
Area of Science:
- Neurodevelopmental disorders
- Pediatric research
- Public health
Context:
- Autism spectrum disorder (ASD) rates are elevated in very low birth weight (VLBW) children.
- Research has evolved from retrospective to prospective studies, refining risk assessment.
- Screening tools like M-CHAT show higher prevalence than diagnostic assessments.
Purpose:
- To conduct a literature review on autism spectrum disorder in very low birth weight children.
- To analyze the evolution of research methodologies and findings in this area.
- To explore hypotheses explaining the increased risk of ASD in premature infants.
Summary:
- Prospective studies indicate 5-8% of VLBW children are diagnosed with ASD, 10-12 times the general population rate.
- Hypotheses include sensory impairments, white matter abnormalities, and cerebellar deficits in premature infants.
- Complex models integrating neurological deficits and caregiver-infant dynamics are proposed for prevention and care.
Impact:
- Informs clinical practice for the early detection and management of ASD in VLBW infants.
- Contributes to a better understanding of neurodevelopmental outcomes in preterm populations.
- Guides the development of targeted interventions and support systems for at-risk children and families.
Abstract:
Research has shown a high rate of autism spectrum disorders among very low birth weight children over the past decade. This paper proposes a literature review on this topic. Two generations of research have followed one another. The first retrospective studies found a high rate of ASD among premature babies. The second generation of prospective studies underlined and relativized this risk. Prospective research using screening tools (M-CHAT) have found around 20 % ASD, whereas 2 studies assessing the actual diagnosis found 5 % and 8 % ASD, 10 to 12 times more than in the general population. A number of hypotheses have been put forward to explain these high rates of ASD: sensory impairment associated with prematurity, white matter abnormalities, and cerebellar impairment. The authors propose complex models that take into account neurological deficits and the effects of perinatal events on interactive dynamics between infants and their caregivers. These models aim to allow suitable prevention and care for premature children with autism, a heavy additional handicap.
