72 Identifying Perinatal and Neonatal Factors Associated with Autism Spectrum Disorder among Preterm Infants Born < 29 Weeks' Gestation. (29th October 2021)

• Record Type: Journal Article
• Authors: Busque, Andrée-Anne; Jabbour, Elias; Patel, Sharina; Couture, Élise; Garfinkle, Jarred; Khairy, May; Claveau, Martine; Beltempo, Marc
• Is Part Of: Paediatrics & Child Health. Volume 26: Supplement 1(2021)
• Page Start: e51
• Page End: e53
• Publication Date: 2021-10-29
• Subjects: Pediatrics -- Periodicals; Children -- Health and hygiene -- Periodicals; 618.92
• DOI: 10.1093/pch/pxab061.057
• Languages: English
• ISSNs: 1205-7088

Abstract

Abstract: Primary Subject area: Neonatal-Perinatal Medicine Background: Preterm infants born &lt;29 weeks&#39; gestational age (GA) are at risk for autism spectrum disorder (ASD), typically diagnosed at age &gt;2 years. Perinatal and neonatal factors, including interventions and morbidities during neonatal intensive care unit admission, may contribute to the risk of ASD among these infants. Objectives: We aimed to assess the incidence of and risk factors for, ASD among preterm infants born &lt; 29 weeks&#39; GA. Design/Methods: &lt;29 weeks&#39; GA admitted 2009-2017 to two tertiary NICUs and followed ≥18 months at the Neonatal Follow-Up Clinic. Primary outcome was ASD defined as a confirmed diagnosis using standardized testing or suspected diagnosis at &gt;18 months of corrected age. Patient data and 18-month developmental outcomes were obtained from the local Canadian Neonatal Follow Up Network database and from chart review. Stepwise logistic regression was used to identify significant perinatal, neonatal, and socio-economic factors associated with ASD. Results: Among 300 eligible infants, 47 (15.7%) developed ASD (Figure 1, Table 1). Mean follow-up duration was 3.9 ± 1.4 years and mean age at diagnosis was 3.7 ± 1.5 years. Male sex (adjusted odds ratio [aOR] 4.63, 95% CI 2.12, 10.10), small for gestational age status (aOR 3.03, 95% CI 1.02, 9.01), maternal age ≥ 35 years at delivery (aOR 2.22, 95% CI 1.08, 4.57), and tobacco use in utero (aOR 5.67, 95% CI 1.86, 17.29) were significantly associated with ASD. Major neonatal morbidities (retinopathy of prematurity, bronchopulmonary dysplasia, necrotizing enterocolitis, late-onset sepsis, severe neurological injury) were not associated with ASD. Among infants with a complete 18-month corrected age developmental assessment and later diagnosed with ASD, 46% (19/41) did not have significant neurodevelopment impairment (Bayley-III &lt; 70, deafness, blindness, or cerebral palsy). Conclusion: ASD is a significant morbidity among infants born &lt; 29 weeks&#39; GA. ASD was associated with infant and prenatal risk factors but not with neonatal morbidities or socio-economic factors. These findings emphasize the need for ASD evaluation among preterm infants &lt; 29 weeks and for reporting developmental outcomes beyond 18-months corrected age.