Abstract TMP87: Higher Prevalence Of Autism Spectrum Disorder In Children With Perinatal Ischemic Stroke

Abstract

Introduction: Perinatal stroke leads to significant morbidity over a child’s lifetime. Following perinatal stroke, children are more likely to be diagnosed with attention-deficit/hyperactivity disorder, intellectual disability, and language disorders. However, to our knowledge, studies examining the prevalence of autism spectrum disorder (ASD) in children with perinatal stroke do not exist. Methods: We retrospectively examined all children seen in the Stroke and Cerebrovascular Center at Boston Children’s Hospital from August 2008 through April 2021. All children with a history of perinatal ischemic stroke, either arterial or venous, aged ≥15 months old at the time of last follow-up were considered for inclusion. We classified patients as having ASD if their medical record included an ASD diagnosis by a neurologist, neuropsychologist, clinical psychologist, or developmental pediatrician. Multivariable logistic regression was performed to examine association between stroke type and ASD. Results: Among 285 children with perinatal stroke, 22 children (7.71%) also had ASD. Males had 8 times higher odds of ASD compared to females (OR= 8.07, p=0.007). Children with perinatal venous stroke had 2.5 times higher odds of ASD compared to those with arterial stroke (OR=2.58, p=0.05), which approached significance. There was not a significant difference in odds of autism in children diagnosed with presumed perinatal stroke compared to neonatal stroke. Conclusion: In our perinatal stroke population, the prevalence of ASD is 4 times higher than the prevalence of ASD in the general U.S. population (1.85%) as per the CDC in 2020. Boys had higher odds of autism, similar to what has been found in the general population. Interestingly, patients with venous stroke had higher odds of autism compared to those with arterial stroke. In conclusion, prospective studies are needed to further investigate the role of perinatal stroke in ASD development.