Evaluation of Autism Spectrum Disorder Risk in Infants With Intraventricular Hemorrhage

Area of Science:

• Neonatal neurology
• Developmental pediatrics
• Neurodevelopmental disorders

Background:

• Intraventricular hemorrhage (IVH) is a common complication in preterm infants.
• Long-term neurodevelopmental outcomes, including autism spectrum disorder (ASD), in infants with IVH require further investigation.
• The Modified Checklist for Autism in Toddlers-Revised with Follow-Up (M-CHAT-R/F) is a validated screening tool for ASD risk.

Purpose of the Study:

• To evaluate the long-term risk of ASD in infants with a history of IVH.
• To assess the association between IVH severity and ASD risk.
• To determine the utility of the M-CHAT-R/F screening tool in this high-risk population.

Main Methods:

• Retrospective cohort study comparing infants with and without IVH admitted to a level IV NICU.
• ASD risk assessed using the M-CHAT-R/F tool at 16-30 months of age.
• Cranial ultrasound (CUS) findings, including periventricular leukomalacia and hydrocephalus, were analyzed for association with ASD risk.

Main Results:

• Severe IVH was significantly associated with a higher risk of ASD (43% vs. 20%) and cerebral palsy (19% vs. 5%).
• Infants with periventricular leukomalacia had 3.24 increased odds of high ASD risk.
• Infants with hydrocephalus requiring a ventriculoperitoneal shunt had 4.75 increased odds of high ASD risk.

Conclusions:

• Severe IVH, unlike mild IVH, is a significant risk factor for developing ASD and cerebral palsy.
• Timely ASD screening is essential for infants with a history of severe IVH.
• Early detection and intervention can lead to better neurodevelopmental outcomes for at-risk infants.