The prevalence and profile of autism in individuals born preterm: a systematic review and meta-analysis

Abstract

Introduction Preterm birth (<37 weeks) adversely affects development in behavioural, cognitive and mental health domains. Heightened rates of autism are identified in preterm populations, indicating that prematurity may confer an increased likelihood of adverse neurodevelopmental outcomes. The present meta-analysis aims to synthesise existing literature and calculate pooled prevalence estimates for rates of autism characteristics in preterm populations. Methods Search terms were generated from inspection of relevant high-impact papers and a recent meta-analysis. Five databases were searched from database creation until December 2020 with PRISMA guidelines followed throughout. Results 10,900 papers were retrieved, with 52 papers included in the final analyses, further classified by assessment method (screening tools N=30, diagnostic assessment N=29). Pooled prevalence estimates for autism in preterm samples was 20% when using screening tools and 6% when using diagnostic assessments. The odds of an autism diagnosis were 3.3 times higher in individuals born preterm than in the general population. Conclusions The pooled prevalence estimate of autism characteristics in individuals born preterm is considerably higher than in the general population. Findings highlight the clinical need to provide further monitoring and support for individuals born preterm.

Bifidobacterium: Host–Microbiome Interaction and Mechanism of Action in Preventing Common Gut-Microbiota-Associated Complications in Preterm Infants: A Narrative Review

“…Poor social communication skills and restricted patterns of repetitive behavior known as autism spectrum disorders (ASD) are other adverse neurodevelopmental outcomes that may develop in preterm infants. Preterm infants have a 3.3 times higher chance of autism diagnosis than full-term infants [ 56 ]. Clinical studies have shown an imbalanced gut microbial composition and metabolites in preterm infants with ASD.…”

Well-being does not predict change in parenting behaviours among mothers of young children at elevated likelihood of autism

“…TIARA is a collaboration between KU Leuven, Ghent University, and societal partners, that is conducted in Flanders, Belgium (www.tiara-onderzoek.be). Children participating in TIARA belong to one of two groups, each with an elevated likelihood of developing autism, namely (a) infant siblings of children with an established autism diagnosis (Messinger et al, 2015;Ozonoff et al, 2011), (b) infants born prematurely, at a gestational age of less than 30 weeks (Agrawal et al, 2018;Laverty et al, 2021, Vermeirsch et al, 2021. Siblings were recruited through centres for developmental disorders, rehabilitation centres, well-baby clinics, home guidance centres, centres for child and adolescent psychiatry, and paediatricians in Flanders, Belgium.…”

“…Given the heritability of autism, siblings have a 7-19.5% chance of developing autism themselves (Messinger et al, 2015;Szatmari et al, 2016), compared to a 0.62-1.7% chance in the general population (Elsabbagh et al, 2012;Maenner et al, 2021). More recently, a second group of prematurely born infants (i.e., infants born at a gestational age of less than 32 weeks; 'pre-terms'), has been identified as being at EL of autism, having a chance of 7-13% to develop autism (Agrawal et al, 2018;Laverty et al, 2021;Vermeirsch et al, 2021). Their EL is thought to be the result of interactions between a biological vulnerability and exposure to environmental stressors that would initiate a foetal immune response, leading to both pre-term birth and altered neurodevelopment (Erdei & Dammann, 2014;Limperopoulos, 2009).…”

Atypical brain network development of infants at elevated likelihood for autism spectrum disorder during the first year of life

“…Given that the socio‐communicative features of ASD usually become visible after the child's first birthday (Szatmari et al, 2016), prospective neuroimaging studies of infants at elevated‐likelihood (EL) for ASD might be able to identify early postnatal changes in the brain that occur before apparent behavioral atypicalities, and thus bridge the gap between early neural development and later ASD characteristics. Accumulated evidence has indicated that infants with genetic or environmental vulnerabilities are more susceptible to ASD than other infants, such as having an older sibling with ASD (Messinger et al, 2015; Ozonoff et al, 2011), and premature delivery (Agrawal et al, 2018; Laverty et al, 2021; Verhaeghe et al, 2016).…”