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The association between preterm delivery and autism spectrum disorder in childhood: A retrospective cohort study

Sapir Ellouk1,2, Omri Zamstein1, Tamar Wainstock2

  • 1Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics
|January 18, 2025
PubMed

Insights

This study found no significant link between preterm birth and autism spectrum disorder (ASD) diagnosis in children. Further research is needed to understand neurodevelopmental outcomes in premature infants.

Area of Science:

  • Perinatal epidemiology
  • Child neurology
  • Developmental pediatrics

Background:

  • Complications of prematurity are a major cause of infant mortality and morbidity.
  • The relationship between preterm birth (PTB) and autism spectrum disorder (ASD) is not well-established.

Purpose of the Study:

  • To investigate the association between preterm birth (PTB) and the diagnosis of autism spectrum disorder (ASD) in childhood.

Main Methods:

  • A retrospective cohort study analyzed data from 114,975 deliveries between 2005 and 2017.
  • ASD incidence was compared across gestational age categories: extremely preterm (<28 weeks), very preterm (28-32 weeks), moderate to late preterm (32-37 weeks), and term (≥37 weeks).
  • Adjusted Cox proportional hazards models and Kaplan-Meier survival curves were used to assess the association, controlling for confounders.

Main Results:

  • Univariable analysis suggested a potential association between PTB and ASD.
  • However, adjusted analyses revealed no statistically significant association between any category of preterm birth and childhood ASD diagnosis.
  • Kaplan-Meier analysis also showed similar cumulative ASD incidence across all gestational age groups.

Conclusions:

  • This study concludes that there is no significant association between preterm birth and the diagnosis of autism spectrum disorder in childhood.
  • These findings contribute to the ongoing debate regarding the neurodevelopmental outcomes of preterm infants.
Abstract

Keywords:
autism spectrum disorderneurodevelopmental disordersprematuritypreterm birth

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