Autism spectrum disorder in children born preterm—role of exposure to perinatal inflammation

Abstract

Autism Spectrum Disorder (ASD) is the collective term for neurodevelopmental disorders characterized by qualitative impairments in social interaction, communication, and a restricted range of activities and interests. Many countries, including Australia, have reported a dramatic increase in the number of diagnoses over the past three decades, with current prevalence of ASD at 1 in every 110 individuals (~1%). The potential role for an immune-mediated mechanism in ASD has been implicated by several studies, and some evidence suggests a potential link between prenatal infection-driven inflammation and subsequent development of ASD. Furthermore, a modest number of contemporary studies have reported a markedly increased prevalence of ASD in children born preterm, who are at highest risk of exposure to perinatal inflammation. However, the mechanisms that underpin the susceptibility to infection-driven inflammation during pregnancy and risk of preterm birth, and how these intersect with the subsequent development of ASD in the offspring, is not understood. This review aims to summarize and discuss the potential mechanisms and evidence for the role of prenatal infection on the central nervous system, and how it may increase the susceptibility for ASD pathogenesis in children born preterm.

Infants Born Late/Moderately Preterm Are at Increased Risk for a Positive Autism Screen at 2 Years of Age

“…45 However, other factors associated with both LMPT birth and ASD may account for this relationship, including advanced maternal age, induction of labor, perinatal inflammation, and preeclampsia. 13,46,47 Given the small number of infants with true positive screens, we were unable to carry out multivariable analyses to adjust for factors that may confound the relationship between ASD and LMPT birth. Where we explored potential associations using univariate analyses, no factors were significantly associated with true positive screens.…”

Prenatal toxoplasmosis antibody and childhood autism

“…Autism is a neurodevelopmental disorder that has been associated with several genetic variants and with environmental factors originating with the mother and the child. Several studies suggest that maternal infections or disruptions in the immune system during the pre‐/perinatal period may increase risk of autism [Brown et al, ; Lee et al, ; Meldrum et al, ; Zerbo et al, ]. Given the effects of congenital Toxoplasma gondii ( T. gondii ), an intracellular parasite, on early brain development [Berrebi et al, ; Roizen et al, ; Swisher et al, ], the infection is a viable prenatal exposure to study in relation to risk of autism.…”

Social development of children born very preterm: a systematic review

“…Currently, a small but growing body of studies suggests that children born VPT are subject to a range of social and behavioral difficulties that may affect their life‐course opportunities . Several contemporary follow‐up studies have also found an increased risk of autism spectrum disorders and related behaviors in survivors of VPT birth . Although suggestive of a possible link between prematurity and later social problems, the interpretation of existing research has been limited by several methodological problems.…”

“…[12][13][14] Several contemporary follow-up studies have also found an increased risk of autism spectrum disor-ders and related behaviors in survivors of VPT birth. [15][16][17] Although suggestive of a possible link between prematurity and later social problems, the interpretation of existing research has been limited by several methodological problems. First, there is considerable variability across studies in the outcomes assessed.…”