Risk factors for Autism Spectrum Disorder (ASD) in Extremely Preterm Children
Introduction: Preterm infants are at increased risk for ASD. It is unknown whether discharge home on respiratory support increases the risk of autism in this population. Our objective is to determine 1) the incidence of ASD, confirmed by the BC Autism Assessment Network (BCAAN), in preterm babies born <26 weeks gestational age (GA) or ≤800 grams birthweight seen at BC Women’s Hospital Neonatal Follow-Up Program (NFUP) and 2) compare the incidence in children discharged home with and without respiratory support.
Methods: Babies born between 2009-2013, <26 weeks GA and/or ≤800 g birthweight without hearing impairment or chromosomal abnormality who attended the NFUP at 3 years and 4.5 years old were included. Children with suspected ASD are referred to BCAAN. A chart review identified children referred to and diagnosed with ASD. Neonatal risk factors and other impairments were ascertained. Proportions were compared using chi-square.
Results: Of 263 NFUP children, 17 were excluded (16 for hearing impairment (2 with ASD); 1 chromosomal abnormality) and 39 had incomplete data. Two were referred but not seen by BCAAN. Out of 207 patients, 23 (11%) were diagnosed with ASD.
Conclusion: As expected, ASD incidence (11%) was higher than in the Canadian pediatric population (1.5%). Children who received home respiratory support had a two- fold higher incidence of ASD, not statistically significant. Results confirm a male preponderance. Very low Bayley-III language score at 18 months corrected is associated with ASD.
Neonatologist and Director of Canadian Neonatal Follow-Up Network Department of Pediatrics, University of British Columbia and BC Children’s and Women’s Hospital and Health Centre, Vancouver, BC, Canada.