G424 Prematurity and the burden of assessment on autistic spectrum disorder diagnostic services: a pragmatic approach

Abstract

Aim Prematurity is a risk factor for autism with prevalence in middle childhood increasing 2–4 fold in preterm versus term populations 1,2,3,4 with a dose-response relationship between gestation and adjusted HR for autism. 1 8% of the EPICure cohort screened positive for ASD at 11 years. 2 There are no pragmatic UK studies examining the burden of the preterm population on ASD assessment services. The aim of this abstract is to determine the burden of autistic spectrum disorder assessments in a cohort of extreme preterm versus moderately preterm versus term children. Methods Retrospective cohort analysis of all preterm deliveries less than 36 weeks gestation from January to December 2009 that survived to discharge. Data gathered from local health records on gestation and gender then cross referenced with local health records to determine whether ASD assessment undertaken. Those with HIE, neurometabolic conditions, congenital cardiac malformations or chromosomal disorders were excluded. Results 198 preterm infants were included. 60 cases in the extreme preterm group. 8.3% of this population underwent ASD assessment by 5 years of age. 138 cases in the moderate preterm group. 4.3% of this population underwent assessment. In the general term population 4202 children were born in 2009. Only 2% of these were assessed for autism. Conclusion Extreme preterm infants are approximately four times more likely to undergo diagnostic assessment for ASD than the term population. Moderately preterm populations are approximately twice as likely to undergo assessment. Recognition of the burden of these high risk groups on ASD assessment services may aid in service provision planning. References Kuzniewicz MW. Prevalence and neonatal factors associated with autism spectrum disorders in preterm infants. J Pediatr. 2014;164:20–5 Johnson S, Hollis C, Kochhar P, et al . Psychiatric disorders in extremely preterm children: longitudinal finding at age 11 years in the EPICure study. J Am Acad Child Adolesc Psychiatry 2010;49:453–63 Hwang Y-S, Weng S-F, Cho C-Y, Tsai W-H. Higher prevalence of autism in Taiwanese children born prematurely: A nationwide population–based study. Res Dev Disabil. 2013;34:2462–2468 Woodward LJ, Bora S, Moor S. Psychiatric outcomes at age 9 of a regional cohort of children born very preterm. J Paediatr Child Health 2012;48:1034–4810