Dados do Trabalho

Título

AUTISM SPECTRUM DISORDER IN PREMATURE PATIENTS: A RETROSPECTIVE REVIEW OF THE PREVALENCE AND MOST COMMON RISK FACTORS IN A COHORT OF 114 PATIENTS FROM THE PREMATURE OUTPATIENT CLINIC OF SAO PAULO, FOLLOWED BETWEEN 2015 AND 2024

Introdução

Autism Spectrum Disorder (ASD) is a lifelong neurodevelopmental condition marked by deficits in social communication and interaction, alongside restrictive and repetitive behaviors. Its global prevalence is estimated at 1.0% to 1.5%. ASD occurs more frequently in children born preterm (6–20%) compared to those born at term. Longitudinal research indicates that preterm infants, even without immediate health issues, have a significantly higher likelihood of adverse neurodevelopmental outcomes later in life. This study aims to compare our findings with existing literature on this topic.

Objetivo

A study of the prevalence and risk factors for later development of autism spectrum disorder in preterm infants treated at the preterm outpatient clinic.

Método

We conducted a retrospective review of medical records from the Premature Infant Neurology Outpatient Clinic, covering the period from 2015 to 2024. This clinic monitors preterm infants born before 34 weeks of gestation and weighing less than 1500 grams. Data collected included parental age, maternal comorbidities, and neonatal conditions.

Resultados

Among 114 patients with adequate follow-up, 15 (13%) were diagnosed with ASD. Of these, 10 (66%) were male and 5 (33%) were female. All mothers had comorbidities: depressive/anxiety disorders (40%), chronic hypertension (33%), pregnancy-related hypertension (40%), eclampsia/pre-eclampsia (33%), pre-gestational diabetes (13%), gestational hypothyroidism (20%), chronic kidney disease (13%), and cervical incompetence (13%). The average maternal age was 31.8 years, paternal age was 36.8 years, with 33% of parents over 40. Comparing our data with the literature: 60% of ASD cases were very preterm (versus 4-6% reported), 5% extremely preterm (vs.5-6.1% reported), and 6% moderately preterm (vs.14% reported). Additionally, 33% had low birth weight, and 46% had an APGAR score below 5 at one minute.

Conclusão

The literature identifies similar ASD risk factors, such as advanced parental age, maternal comorbidities (especially psychiatric disorders and chronic hypertension), and neonatal factors like birth asphyxia and low birth weight. Our findings are consistent with these established risks. However, results regarding postnatal factors like steroid therapy, neonatal physiological functioning, and intracranial hemorrhages remain controversial. This highlights the crucial need for early developmental screening for ASD and other neurological conditions, enabling timely diagnosis and intervention to enhance outcomes.

Referências

1. Cogley C, O'Reilly H, Bramham J, Downes M. A Systematic Review of the Risk Factors for Autism Spectrum Disorder in Children Born Preterm. Child Psychiatry Hum Dev. 2021 Oct;52(5):841-855. doi: 10.1007/s10578-020-01071-9. Epub 2020 Sep 27. PMID: 32980936.

2. Crump C, Sundquist J, Sundquist K. Preterm or Early Term Birth and Risk of Autism. Pediatrics. 2021 Sep;148(3):e2020032300. doi: 10.1542/peds.2020-032300. Epub 2021 Aug 11. PMID: 34380775; PMCID: PMC9809198.

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Palavras Chave

AUTISM SPECTRUM DISORDER; neuropsychiatric disorders; preterm birth