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Risk Factors for Autism Spectrum Disorder in Individuals Born Preterm: A Systematic Review and Meta-Analysis of
Bo Yang1, Nina Zaks2, Eero Kajantie3,4,5,6
1JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
Biological Psychiatry Global Open Science
|July 18, 2025
Summary
Preterm children face higher autism spectrum disorder (ASD) risks. Male sex is a confirmed risk factor, with low birth weight showing potential association. More research is needed to clarify ASD causes in preterm infants.
Area of Science:
- Neurodevelopmental Disorders
- Perinatal Medicine
- Epidemiology
Background:
- Preterm birth is linked to increased autism spectrum disorder (ASD) risk.
- Determinants of ASD in preterm infants are not well understood.
- This study systematically reviews risk factors for ASD in preterm populations.
Purpose of the Study:
- To summarize population-based literature on ASD risk factors in preterm-born individuals.
- To identify consistent risk factors through systematic review and meta-analysis.
- To highlight knowledge gaps in ASD etiology for preterm infants.
Main Methods:
- Systematic search of Ovid MEDLINE, Embase, and Web of Science databases.
- Inclusion of 19 population-based studies (cohort, case-control, cross-sectional).
- Meta-analysis of risk factors examined in at least two studies, following PRISMA guidelines.
Main Results:
- Male sex identified as a significant risk factor for ASD in preterm infants (RR 3.04).
- Low birth weight suggested a potential association with ASD.
- Neonatal jaundice showed no clear link; other factors examined in limited studies.
Conclusions:
- Significant knowledge gaps persist regarding ASD risk factors in preterm infants.
- Male sex is the only consistent risk factor identified.
- Further research is crucial to understand ASD etiology differences between preterm and term-born individuals.
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