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Autism Spectrum Disorder in Children With Perinatal Ischemic Stroke Varies by Stroke Type
Clara M Wu1, Bo Zhang1,2, Cameron C Trenor2,3,4
1Neurology Department, Boston Children's Hospital, Boston, MA, USA.
Insights
Children with perinatal venous stroke show a higher likelihood of developing autism spectrum disorder (ASD) compared to those with arterial stroke. This finding highlights the importance of considering stroke type in neurodevelopmental assessments.
Area of Science:
- Neurology
- Pediatrics
- Developmental Neuroscience
Background:
- Perinatal stroke is a significant cause of lifelong neurodevelopmental disorders in children.
- Limited research exists on the prevalence of autism spectrum disorder (ASD) following perinatal stroke.
- Clinical observations prompted an investigation into ASD rates in pediatric stroke patients.
Purpose of the Study:
- To determine the rate of autism spectrum disorder (ASD) diagnosis in children with perinatal ischemic stroke.
- To analyze the association between different perinatal ischemic stroke subtypes and ASD diagnosis.
Main Methods:
- Retrospective analysis of children diagnosed with perinatal ischemic stroke (≥18 months at last follow-up, 2008-2021).
- ASD diagnosis confirmed by neurologists, neuropsychologists, psychologists, or developmental pediatricians.
- Multivariable logistic regression used to assess stroke subtype and ASD association.
Main Results:
- Out of 260 children with perinatal stroke, 19 (7.3%) were diagnosed with ASD.
- Children with perinatal venous stroke had triple the odds of ASD compared to those with perinatal arterial ischemic stroke (aOR: 3.01, 95% CI: 1.07-8.47).
Conclusions:
- Perinatal venous stroke is associated with increased odds of autism spectrum disorder compared to perinatal arterial ischemic stroke.
- Further prospective research is necessary to elucidate the role of perinatal stroke in ASD development.
Abstract:
Background and Objectives: Perinatal stroke leads to significant morbidity over a child's lifetime, including diagnosis of various neurodevelopmental disorders. Specific studies examining the prevalence of autism spectrum disorder in children with perinatal stroke are scarce. Following the clinical observation of autism spectrum disorder in a pediatric referral stroke center, we evaluated the rate of autism spectrum disorder diagnosis after perinatal ischemic stroke, including analysis by subtypes of perinatal ischemic stroke. Methods: We retrospectively examined all children diagnosed with perinatal ischemic stroke, who were ≥18 months old at the time of last follow-up at a single institution from 2008 through 2021. We classified patients as having autism spectrum disorder if they were diagnosed by a neurologist, neuropsychologist, clinical psychologist, or developmental pediatrician. Multivariable logistic regression was performed to examine the association between ischemic stroke subtype and autism spectrum disorder. Results: Among 260 children with perinatal stroke, 19 children (7.3%) also had autism spectrum disorder. Children with perinatal venous stroke had 3-fold higher odds of autism spectrum disorder compared to those with perinatal arterial ischemic stroke (adjusted odds ratio: 3.01, 95% confidence interval: 1.07-8.47). Conclusion: In our perinatal ischemic stroke population, children with venous stroke had higher odds of autism spectrum disorder compared to those with arterial ischemic stroke alone. Prospective studies are needed to further investigate the role of perinatal stroke in autism spectrum disorder development.
