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Birth weight and autism spectrum disorder: A population-based nested case-control study.

Ziv Talmi1,2, David Mankuta2,3, Raanan Raz1

  • 1Braun School of Public Health and Community Medicine, The Hebrew University Hadassah, Jerusalem, Israel.

Autism Research : Official Journal of the International Society for Autism Research
|January 14, 2020
PubMed
Summary

Autism spectrum disorder (ASD) risk is linked to birth weight (BW) and gestational age (GA) beyond typical cutoffs. Even BW below 3,000g and earlier GA are associated with increased ASD likelihood in the Israeli population.

Keywords:
autism spectrum disorderbirth weightcase-control studyepidemiologyperinatal risk factors

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Area of Science:

  • Neurodevelopmental Disorders
  • Perinatal Epidemiology
  • Genetics and Genomics

Background:

  • Autism spectrum disorder (ASD) is a neurodevelopmental condition with increasing prevalence.
  • Previous studies suggest associations between ASD and deviations in birth weight (BW) and gestational age (GA), particularly low BW (<2,500g) and preterm birth (<37 weeks).
  • However, the full spectrum of BW and GA risks for ASD remains incompletely understood.

Purpose of the Study:

  • To investigate the association between a wide range of birth weight (BW) and gestational age (GA) and the risk of autism spectrum disorder (ASD) in the Israeli population.
  • To determine if these associations extend beyond commonly used clinical cutoffs for low BW and preterm birth.

Main Methods:

  • A population-nested case-control study utilizing Israeli National Insurance Institute records.
  • Inclusion of 12,635 children diagnosed with ASD (cases) and a 20% random sample of unaffected children (controls) born between 2000 and 2012.
  • Multiple logistic regression models adjusted for covariates including child sex, parental age, socioeconomic status, and multiple gestation were used to calculate adjusted odds ratios (AORs).

Main Results:

  • Birth weight below 3,000g was associated with a higher risk of ASD (e.g., BW 2,500-3,000g: AOR 1.18).
  • Gestational age below 39 weeks was also linked to increased ASD risk (e.g., 37-38 weeks: AORs 1.35 and 1.13, respectively).
  • Modeling BW percentiles for GA revealed that BW below the 20th percentile was associated with increased ASD risk (AOR 1.10).

Conclusions:

  • The association between birth weight, gestational age, and autism spectrum disorder risk is not limited to the established clinical definitions of low birth weight and preterm birth.
  • These findings highlight the importance of considering a broader range of birth weight and gestational age parameters when assessing ASD risk.
  • The study underscores the complex interplay between perinatal factors and neurodevelopmental outcomes.