Study Finds No Link Between Preterm Birth and Childhood Autism Diagnosis

Preterm birth, defined as delivery before 37 weeks of gestation, has been linked to various health complications, including developmental delays and neurological disorders. Autism spectrum disorder, a developmental disorder characterized by challenges in social interaction, communication, and behavior, has been a concern for many parents and healthcare professionals, particularly in the context of preterm birth.

The relationship between preterm birth and autism spectrum disorder remains a topic of ongoing debate. To explore this, Sapir Ellouk, Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel, and colleagues aimed to examine the link between PTB and ASD diagnoses in childhood.

For this purpose, the researchers conducted a cohort study analyzing data from community clinics and a tertiary hospital, covering deliveries from 2005 to 2017. They compared the incidence of autism spectrum disorder across different gestational age categories: extremely preterm (<28 weeks), very preterm (28–32 weeks), moderate to late preterm (32–37 weeks), and term (≥37 weeks). Additional comparisons were made between all preterm births (<37 weeks) and term births (≥37 weeks).

Cumulative ASD incidence was evaluated using Kaplan–Meier survival curves and a Cox proportional hazards model, adjusting for potential confounding factors.

The following were the key findings of the study:

• Among 114,975 pregnancies, 0.3% delivered at <28 weeks, 0.6% at 28–32 weeks, and 6% at 32–37 weeks, resulting in an overall preterm delivery rate of 6.9%.
• Univariable analysis revealed a significant association between preterm birth and autism spectrum disorder, with rates of 1.6% for <28 weeks, 0.3% for 28–32 weeks, 0.8% for 32–37 weeks, and 0.7% for term births.
• The crude ASD incidence was 0.8%, with an odds ratio (OR) of 1.21.
• However, adjusted results showed no significant association, with an adjusted hazard ratio of 0.74 for <28 weeks, 0.99 for 28–32 weeks, and 1.07 for 32–37 weeks.
• Kaplan–Meier analysis showed similar cumulative ASD incidence across all gestational age groups.

"Our retrospective cohort study found no significant association between preterm birth and the diagnosis of autism spectrum disorder in childhood," the researchers concluded.

Reference:

Ellouk, S., Zamstein, O., Wainstock, T., & Sheiner, E. The association between preterm delivery and autism spectrum disorder in childhood: A retrospective cohort study. International Journal of Gynecology & Obstetrics. https://doi.org/10.1002/ijgo.16150