Mortality of Children with Autism Spectrum Disorder Using Data from a Large-Scale Korean National Cohort

Abstract

Purpose This study aimed to investigate the association between autism spectrum disorder (ASD) diagnosis and mortality among children using the data from a large-scale national cohort of Korean infants and children. We also explored the association between hearing impairment detected during early infancy and mortality. Materials and Methods We performed a retrospective cohort study using the nationwide claims data of the Republic of Korea. Children born between 2007 and 2014 (n=3598904) were followed up until 2020. Cox proportional hazard models were used to examine the association between ASD diagnosis and mortality among children. Then, in order to evaluate the association between hearing impairment and mortality, Cox proportional hazard models were built using the responses related to hearing impairment asked during the first health screening (at age 4–6 months). Results Of the 3598904 children born between 2007 and 2014, 32878 children (0.9%) were diagnosed with ASD until the end of 2020. We identified that ASD diagnosis was associated with higher mortality among children [hazard ratio (HR)=2.5, 95% confidence interval (CI): 2.2–2.9]. This association was stronger among girls (HR=4.8, 95% CI: 3.9–5.8) compared to boys (HR=1.9, 95% CI: 1.6–2.2). We found that hearing impairment detected during infancy was associated with higher mortality among children with ASD diagnosis. Conclusion ASD diagnosis was associated with higher mortality among Korean children. This association was stronger in girls than in boys. Hearing impairment detected during infancy was also associated with higher mortality among children diagnosed with ASD.

Prevalence of Pediatric Autism Spectrum Disorder in Korea Using National Statistics Including the COVID-19 Pandemic, 2011 to 2021

“…We performed this retrospective study using information from the NHIS in Korea. We used data on ASD (codes F84.0, F84.1, F84.5, F88.8, or F88.9 according to the International Classification of Diseases [ICD], 10th revision), as in a previous study, through the homepage of the NHIS (http://www.nhis.or.kr) that provides various information [11]. This information is based on insurance claims submitted by doctors after examining ASD patients from 2011 to 2021.…”

Excess Mortality in Individuals with Autism Spectrum Disorder: A Population-Based Cohort Study

“…Previous studies may not have incorporated the income of the family into their research, [11][12][13][14]19,22 although some considered it a confounding factor. 23 A previous study showed that the mortality rate associated with ASD increased across all income classes. 20 Another study found no difference in the income of the family concerning ASD mortality.…”