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Prevalence of Autism Spectrum Disorder in Preterm Infants: A Meta-analysis
Sachin Agrawal1, Shripada C Rao2,3, Max K Bulsara4
1Neonatal Unit, King Edward Memorial Hospital for Women and Perth Children Hospital, Nedlands, Western Australia, Australia.
Insights
Preterm infants have a high risk of autism spectrum disorder (ASD). This systematic review found a 7% prevalence of ASD in preterm children, highlighting the need for targeted support.
Area of Science:
- Neonatal research
- Developmental pediatrics
- Neurodevelopmental disorders
Background:
- Emerging evidence suggests preterm infants are at increased risk for autism spectrum disorder (ASD).
- Understanding the prevalence of ASD in this vulnerable population is crucial for early intervention and support.
Purpose of the Study:
- To systematically review and meta-analyze the prevalence of ASD in preterm infants.
- To provide an updated estimate of ASD prevalence based on diagnostic assessments.
Main Methods:
- A systematic search of Medline, Embase, PsycINFO, and conference proceedings was conducted.
- Included original studies reporting ASD prevalence using diagnostic tests in preterm children; excluded studies using only screening tools.
- Data from 18 studies involving 3366 preterm infants were extracted and meta-analyzed.
Main Results:
- The meta-analysis included 18 studies with 3366 preterm infants.
- The overall prevalence of ASD in preterm infants was estimated at 7% (95% CI: 4% to 9%).
- No significant evidence of publication bias was detected.
Conclusions:
- The prevalence of ASD is significantly elevated in the preterm population.
- There is a critical need for adequate resources and early intervention strategies for preterm infants at risk of ASD.
- Further research is needed, particularly from middle- and low-income countries, to address heterogeneity.
Context:
Evidence is emerging that preterm infants are at risk for autism spectrum disorder (ASD).
Objectives:
To conduct a systematic review and meta-analysis to estimate the prevalence of ASD in preterm infants.
Data Sources:
Medline (via PubMed and Ovid), Embase, PsycINFO, and relevant conference proceedings were searched in May 2017.
Study Selection:
Original studies in which researchers report on the prevalence of ASD using diagnostic tests in children born preterm were included. Studies in which researchers used only ASD screening tools were excluded.
Data Extraction:
Relevant data were extracted independently by 3 authors.
Results:
Researchers in a total of 18 studies (3366 preterm infants) used ASD diagnostic tools. The median gestation, birth weight, and age at assessment were 28.0 weeks (range: 25.1-31.3 weeks), 1055 g (range: 719-1565 g), and 5.7 years (range: 1.5-21 years), respectively. Meta-analysis revealed that the overall prevalence rate for ASD was 7% (95% confidence interval: 4% to 9%). The funnel plot and Egger's test revealed that there was probably no evidence of publication bias.
Limitations:
The limitations were significant heterogeneity and a lack of studies from middle- and low-income countries.
Conclusions:
The prevalence of ASD is significantly high in the preterm population. Adequate resources are needed to improve the outcomes of these children.
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