Higher prevalence of autism in Taiwanese children born prematurely: a nationwide population-based study.
Kids born before 34 weeks have 3-4 times higher autism rates, so screen them early.
01Research in Context
What this study did
Researchers looked at every child born in Taiwan from 1997-2001. They checked birth records and autism diagnoses for 8-11 year olds. They split kids into three groups: early preterm (before 34 weeks), late preterm (34-36 weeks), and full term (37+ weeks).
What they found
Early preterm kids had autism at a large share. Late preterm kids had a large share. Full term kids had only a large share. Boys born very early had the highest risk. Very low birth weight and brain problems after birth added extra risk.
How this fits with other research
Duker et al. (1991) first looked at birth issues in autism, but only studied high-functioning kids. They found only small effects. Hwang et al. (2013) shows the full picture using all kids in Taiwan. The bigger sample reveals much stronger links between early birth and autism.
Tioleco et al. (2021) found that mom's infections during pregnancy also raise autism risk. This works alongside prematurity - some early births happen because of infections. Both studies help us see autism risk starts before birth.
Tseng et al. (2016) used the same Taiwan registry but looked at mom's nationality instead of birth timing. This shows the registry data is reliable for tracking different risk factors across the whole country.
Why it matters
When you see a child born months early, screen for autism early and often. These kids need watching before age 2. Share this data with neonatal teams - they can flag high-risk babies for you. Early intensive ABA works best when we start right after diagnosis.
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02At a glance
03Original abstract
The reported prevalence of autism in preterm and full-term children varies partially because of small sample sizes. Moreover, little is known about the specific factors that contribute to the risk of autism in preterm children. We aimed to compare the prevalence of autism in preterm and full-term children and to identify neonatal risk factors for autism in preterm children using a large national health system database. We analyzed data from 1078 early preterm (<28 weeks of gestation or birth weight<1000 g), 28,947 later preterm (28-36 weeks), and 1,104,071 full-term (≥ 37 weeks) children who were 8-11 years old in 2009. The descending order of prevalence was early preterm (2.2%), later preterm (1.3%), and full-term (0.6%). The prevalence of autism was approximately 2-4 times higher in preterm children than in children born at full-term. The male-female ratio (4:1) in preterm and full-term children was not significantly different. Most of the children were first diagnosed with autism between 3 and 6 years old. Preterm children with autism were not diagnosed earlier than were full-term children. Regression analysis showed that male gender, a very low birth weight, and neonatal cerebral dysfunction were risk factors for autism in the preterm group. We conclude that autism is more prevalent in preterm children. Preventing extremely preterm birth and significant early brain insults may be helpful in reducing the risk of autism in preterm children.
Research in developmental disabilities, 2013 · doi:10.1016/j.ridd.2013.05.019