PP10.1 – 3049: The incidence of autistic spectrum disorder in a cohort of 213 prematurely born children

Abstract

Objective Preterm birth is emerging as a major health problem in the developed world. A significant modern risk factor is the widespread use of assisted reproductive technology (ART). We aim to prospectively study the additional risk of ART for developing autistic spectrum disorder (ASD) in comparison to naturally conceived preterm. Methods We prospectively followed 213 children of a cohort of 283 very low birth weight newborns born between 1998 and 2002. Their mean age was 12.8 years, 46% were males and 56% were the result of multiple pregnancies. 33% were conceived by ART while the mean gestational age was 30.8±2.4 and the mean birth weight was 1237±266 grams. The medical charts of all the participants were reviewed for neonatal complications, developmental milestones and current behavioral diagnoses. ASD was assessed using the A.S.S.Q. (Autism Spectrum Screening Questionnaire). Results The incidence of ASD was 24/213 (11.3%) and other neurodevelopmental comorbidities were: attention deficit hyperactivity disorder (ADHD, 26%), learning disabilities (25%), cerebral palsy (CP, 11%), epilepsy (6%) and intellectual disability (3%). No significant differences were found in the incidence of ASD and other neurodevelopmental comorbidities between the ART and naturally conceived groups. The ASD and non-ASD groups did not differ in birth weight, gestational age and Apgar score. However, significant differences were found for male gender (p=0.015), ADHD (p=0.085), epilepsy (p=0.033) and intellectual disability (ID, p=0.004). Conclusion We found the incidence of ASD in a cohort of preterms to be approximately ten times the incidence reported in the general Israeli population. ART was not found to be a risk factor for any neurodevelopmental disorder. ASD was not found to be associated with a lower Apgar score or CP. The association between ASD and male gender, ADHD, epilepsy and ID is well known and also evident in our cohort.