Preterm birth not associated with autism development
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Key takeaways:
- Being born early preterm, late preterm or at term was not associated with an autism diagnosis.
- Results persisted after adjusting for ethnicity, small for gestational age, maternal age and fetal sex.
Preterm birth was not associated with the development of autism spectrum disorder in childhood, according to findings presented at The Pregnancy Meeting.
“In a situation where both the rates of premature births and autism are increasing, it becomes crucial, when suspecting autism, to investigate more established factors that are firmly linked to autism,” Sapir Ellouk, MD, MPH, resident in the Saban Birth & Maternity Center at Soroka Medical Center, Israel, told Healio. “It’s important not to automatically attribute the sole cause of autism in offspring to perinatal factors without careful consideration.”
Ellouk and colleagues conducted a cohort analysis utilizing population-based data from 139,859 deliveries that occurred from 2005 to 2017 from community clinics and a tertiary referral hospital in Israel. Researchers compared autism diagnoses in children based on timing of delivery — early preterm, late preterm or term.
Overall, 1.2% were early preterm and 4.1% were late preterm infants. Earlier gestational age at birth was associated with some obstetrical characteristics, including primiparity, lower 5-minute Apgar score and male sex (P < .001 for all). Researchers observed no significant association between preterm birth and diagnosis of autism for those born early preterm, late preterm and term.
After adjusting for ethnicity, small for gestational age, maternal age and fetal sex, researchers continued to observe no significant association between being born early or late preterm and autism development compared with term delivery.
According to Ellouk, the presence of conflicting studies on the association between prematurity and autism is surprising and highlights the need to analyze this relationship and the mechanisms that may potentially obscure the “true nature” of the association.
“Conducting prospective multicentric studies is imperative in addressing the elusive nature of understanding the causes and processes leading to the development of autism. Various factors, including genetic, epigenetic, environmental and social influences, have been associated with autism over time,” Ellouk said. “With continuous advancements in scientific research and the identification of numerous genetic mutations and changes in DNA associated with autism, I propose that these prospective multicentric studies should specifically focus on examining the association of perinatal characteristics and specific mutations. This approach will allow us to investigate whether there is a genetic component supporting the associations identified in previous research, thereby enabling us to initiate discussions about causation.”
For more information:
Sapir Ellouk, MD, MPH, can be reached at sapirellouk@gmail.com.