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Incidence and risk factors for autism spectrum disorder among infants born <29 weeks' gestation

Andrée-Anne Busque1, Elias Jabbour2, Sharina Patel1,2

  • 1McGill University, Montreal, Quebec, Canada.

Paediatrics & Child Health
|October 6, 2022
PubMed

Insights

Autism spectrum disorder (ASD) affects 15.7% of preterm infants born before 29 weeks gestational age. Risk factors include male sex, small for gestational age, older maternal age, and smoking during pregnancy.

Area of Science:

  • Neonatal Intensive Care
  • Developmental Pediatrics
  • Neuroscience

Background:

  • Preterm infants born before 29 weeks gestational age (GA) are at increased risk for neurodevelopmental disorders.
  • Autism spectrum disorder (ASD) is a significant concern in this vulnerable population.
  • Understanding the incidence and risk factors for ASD in extremely preterm infants is crucial for early intervention.

Purpose of the Study:

  • To determine the incidence of autism spectrum disorder (ASD) in infants born before 29 weeks gestational age (GA).
  • To identify risk factors associated with the development of ASD in this cohort.
  • To evaluate neurodevelopmental outcomes in extremely preterm infants diagnosed with ASD.

Main Methods:

  • A retrospective cohort study included infants born <29 weeks GA admitted to tertiary neonatal intensive care units from 2009-2017.
  • Infants were followed up to at least 18 months corrected age (CA) for ASD diagnosis using standardized assessments.
  • Stepwise logistic regression analysis was employed to identify factors associated with ASD.

Main Results:

  • The combined incidence of confirmed and provisional ASD was 15.7% among 300 eligible infants.
  • Significant risk factors for ASD included male sex (aOR 4.63), small for gestational age (aOR 3.03), maternal age ≥35 (aOR 2.22), and smoking during pregnancy (aOR 5.67).
  • Among infants with ASD and complete 18-month assessments, 46% had no other neurodevelopmental impairment.

Conclusions:

  • Autism spectrum disorder (ASD) is common in extremely preterm infants (<29 weeks GA).
  • Identified risk factors highlight potential targets for preventative strategies and early screening.
  • Continued monitoring of developmental outcomes beyond 18 months corrected age is essential for this population.
Abstract

Keywords:
Autism spectrum disorderNeurodevelopmental outcomesPrematurity

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