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Early autism risk factors: a cohort study of children born very preterm at 5-years
Meg Stone-Heaberlin1,2, Allison D Blackburn1,2, Leanne Tamm3,4,5
1Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Insights
Very preterm (VPT) children have higher autism risk, linked to factors like male sex, cerebellar issues, and chorioamnionitis. Early screening for these risks in VPT infants can improve neurodevelopmental outcomes.
Area of Science:
- Neurodevelopmental disorders
- Pediatric research
- Autism Spectrum Disorder (ASD) etiology
Background:
- Very preterm (VPT) birth is associated with increased risk of neurodevelopmental challenges.
- Understanding specific risk factors for autism in VPT children is crucial for early intervention.
- Previous research has identified various prenatal, perinatal, and postnatal factors influencing neurodevelopment.
Purpose of the Study:
- To investigate the association between prenatal, perinatal, and postnatal risk factors and autism risk in very preterm (VPT) children at 5-years corrected age.
- To identify specific risk factors that predict autism risk in the VPT population.
- To compare autism risk between VPT and term-born children.
Main Methods:
- Longitudinal cohort study including 315 VPT and 172 term-born children.
- Elastic net regression analysis to explore antecedents of autism risk.
- Utilized the Social Communication Questionnaire (SCQ) to assess autism risk (SCQ ≥ 15).
Main Results:
- VPT children (8.9%) showed a higher prevalence of autism risk (SCQ ≥ 15) compared to term-born controls (2.9%; p=0.012).
- Significant risk factors for autism in VPT children included male sex, social risk, cerebellar abnormalities (OR=1.339), and moderate-to-severe histologic chorioamnionitis (OR=4.148).
- VPT children with autism risk (SCQ ≥ 15) exhibited poorer adaptive, behavioral, cognitive, and executive functioning (all p < 0.001).
Conclusions:
- Specific risk factors, including cerebellar abnormalities and chorioamnionitis, are significantly associated with autism risk in very preterm children.
- Early identification of these risk factors in VPT children is essential for timely intervention.
- Targeted screening can facilitate early intervention, potentially improving neurodevelopmental outcomes for high-risk VPT children.
Objective:
Explore the association of prenatal, perinatal, and postnatal risk factors with autism risk at 5-years corrected age in very preterm (VPT) children.
Study Design:
Data from a longitudinal cohort study of 315 VPT and 172 term-born children at a US-based academic medical center were analyzed, exploring antecedents of autism risk using elastic net regression.
Results:
More children born VPT (8.9%) had a Social Communication Questionnaire score associated with autism (i.e., SCQ ≥ 15) than term-born controls (2.9%; p = 0.012). For VPT children, cerebellar abnormalities at term-equivalent age (OR = 1.339, 95% CI = 1.010-1.778) and moderate-severe histologic chorioamnionitis (OR = 4.148, CI = 1.294-13.368) were significantly associated with autism risk, in addition to male sex and social risk. VPT children with SCQ ≥ 15 had poorer adaptive, behavioral, cognitive, and executive functioning (all ps < 0.001).
Conclusion:
Early screening for children with these risk factors can facilitate early intervention for those at most risk for poorer neurodevelopmental outcomes.
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