A-051 Identifying Autism in Children With a History of Extreme Prematurity: A Case Series

Abstract

Abstract Objective Children with a history of prematurity are at increased risk for neurodevelopmental disorders, including autism. This case series describes four patients with comparable prenatal and divergent neonatal histories who were referred for comprehensive autism evaluations between 21-36 months of age by a NICU follow-up program. Method Patients were born at approximately 25 weeks gestation (i.e. extremely premature) following otherwise uncomplicated pregnancies and weighed less than 1000 grams at birth (i.e. extremely low birth weight). Patients A and B experienced significant neonatal complications (e.g. hemorrhage, respiratory failure). Children were later evaluated for autism by an interprofessional team affiliated with a children’s hospital. Results Patient A had average intellectual, motor, and language abilities with mild symptoms of autism on a standardized rating scale. Patient B had impaired intellectual, motor, and language abilities with severe symptoms of autism on the same rating scale. Patient C had average intellectual abilities, borderline language and motor abilities, and did not display autism features. Patient D had borderline intellectual abilities, low average receptive and expressive language, and also did not display autism features. Conclusions All patients presented with developmental delays in at least one domain. Those who experienced complications in the NICU met DSM-5 criteria for Autism Spectrum Disorder. However, patients with similar prenatal histories who did not face additional complications in the NICU presented with comparatively intact social communication and behavior. This case series suggests the relative importance of peri- and neonatal factors in the etiology of autism in children with a history of extreme prematurity.