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Neonatal Autonomic Regulation as a Predictor of Autism Spectrum Disorder in Very Preterm Infants
Medrxiv : the Preprint Server for Health Sciences
|November 28, 2023
Summary
Autonomic nervous system (ANS) dysfunction in very preterm infants may predict autism spectrum disorder (ASD) risk. Early ANS measures, like heart rate characteristics, show strong associations with later ASD symptoms, offering potential biomarkers.
Area of Science:
- Neonatology
- Neurodevelopmental disorders
- Autonomic nervous system (ANS) research
Background:
- Infants born very preterm (VPT) have a higher risk of autism spectrum disorder (ASD).
- Autonomic nervous system (ANS) dysfunction is a shared characteristic of preterm birth and ASD.
- VPT infants may represent a critical window for understanding ANS dysfunction as a pathway to ASD.
Approach:
- Collected continuous autonomic nervous system (ANS) data, including thermal gradients and heart rate characteristics (HRCs), from 20 very preterm infants from birth to 28 days.
- Assessed cognitive, language, motor, and social-communication skills at 6, 9, and 12 months, including early ASD symptom evaluation at 12 months.
- Analyzed the association between neonatal ANS measures and 12-month ASD symptoms, controlling for gestational age and birth weight.
Key Points:
- Half of the very preterm infants in the study showed significant ASD concerns by 12 months of age.
- Neonatal abnormal heart rate characteristics (HRCs) were strongly correlated with 12-month ASD symptoms (r=0.81, p<.01).
- Early ANS measures, including thermal gradients and HRCs, collected within the first month of life, predicted later ASD symptoms.
Conclusions:
- Autonomic nervous system (ANS) dysfunction in early neonatal life is a significant predictor of later autism spectrum disorder (ASD) symptoms in very preterm infants.
- Imbalances in the sympathetic and parasympathetic systems, reflected in ANS measures, may disrupt early regulatory processes, contributing to ASD development.
- Complementary ANS measures show promise as potential etiological markers and biomarkers for researching ASD in preterm populations.
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