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Can association between preterm birth and autism be explained by maternal or neonatal morbidity?
Pediatrics. 2009 Nov; 124(5):e817-25.Ped

Abstract

OBJECTIVE

We examined whether an association between preterm birth and risk of autistic disorders could be explained by pregnancy complications or neonatal morbidity.

METHODS

This Swedish, population-based, case-control study included 1216 case subjects with autistic disorders who were born between 1987 and 2002 and 6080 control subjects who were matched with respect to gender, birth year, and birth hospital. We assessed associations between gestational age and autistic disorders and adjusted for maternal, birth, and neonatal characteristics. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS

Compared with infants born at term, the unadjusted ORs for autistic disorders among very and moderately preterm infants were 2.05 [95% CI: 1.26-3.34] and 1.55 [95% CI: 1.22-1.96], respectively. When we controlled for maternal, pregnancy, and birth characteristics, ORs were reduced to 1.48 [95% CI: 0.77-2.84] and 1.33 [95% CI: 0.98-1.81], respectively. When we also controlled for neonatal complications, ORs were 0.98 [95% CI: 0.45-2.16] and 1.25 [95% CI: 0.90-1.75], respectively. Reductions in risks of autistic disorders related to preterm birth were primarily attributable to preeclampsia, small-for-gestational age birth, congenital malformations, low Apgar scores at 5 minutes, and intracranial bleeding, cerebral edema, or seizures in the neonatal period. Neonatal hypoglycemia, respiratory distress, and neonatal jaundice were associated with increased risk of autistic disorders for term but not preterm infants.

CONCLUSION

The increased risk of autistic disorders related to preterm birth is mediated primarily by prenatal and neonatal complications that occur more commonly among preterm infants.

Authors+Show Affiliations

Department of Medical Epidemiology and Biostatistics, Karolinska Institute, PO Box 281, SE-171 77 Stockholm, Sweden. susanne.buchmayer@ki.seNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19841112

Citation

Buchmayer, Susanne, et al. "Can Association Between Preterm Birth and Autism Be Explained By Maternal or Neonatal Morbidity?" Pediatrics, vol. 124, no. 5, 2009, pp. e817-25.
Buchmayer S, Johansson S, Johansson A, et al. Can association between preterm birth and autism be explained by maternal or neonatal morbidity? Pediatrics. 2009;124(5):e817-25.
Buchmayer, S., Johansson, S., Johansson, A., Hultman, C. M., Sparén, P., & Cnattingius, S. (2009). Can association between preterm birth and autism be explained by maternal or neonatal morbidity? Pediatrics, 124(5), e817-25. https://doi.org/10.1542/peds.2008-3582
Buchmayer S, et al. Can Association Between Preterm Birth and Autism Be Explained By Maternal or Neonatal Morbidity. Pediatrics. 2009;124(5):e817-25. PubMed PMID: 19841112.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Can association between preterm birth and autism be explained by maternal or neonatal morbidity? AU - Buchmayer,Susanne, AU - Johansson,Stefan, AU - Johansson,Anna, AU - Hultman,Christina M, AU - Sparén,Pär, AU - Cnattingius,Sven, Y1 - 2009/10/19/ PY - 2009/10/21/entrez PY - 2009/10/21/pubmed PY - 2010/1/1/medline SP - e817 EP - 25 JF - Pediatrics JO - Pediatrics VL - 124 IS - 5 N2 - OBJECTIVE: We examined whether an association between preterm birth and risk of autistic disorders could be explained by pregnancy complications or neonatal morbidity. METHODS: This Swedish, population-based, case-control study included 1216 case subjects with autistic disorders who were born between 1987 and 2002 and 6080 control subjects who were matched with respect to gender, birth year, and birth hospital. We assessed associations between gestational age and autistic disorders and adjusted for maternal, birth, and neonatal characteristics. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: Compared with infants born at term, the unadjusted ORs for autistic disorders among very and moderately preterm infants were 2.05 [95% CI: 1.26-3.34] and 1.55 [95% CI: 1.22-1.96], respectively. When we controlled for maternal, pregnancy, and birth characteristics, ORs were reduced to 1.48 [95% CI: 0.77-2.84] and 1.33 [95% CI: 0.98-1.81], respectively. When we also controlled for neonatal complications, ORs were 0.98 [95% CI: 0.45-2.16] and 1.25 [95% CI: 0.90-1.75], respectively. Reductions in risks of autistic disorders related to preterm birth were primarily attributable to preeclampsia, small-for-gestational age birth, congenital malformations, low Apgar scores at 5 minutes, and intracranial bleeding, cerebral edema, or seizures in the neonatal period. Neonatal hypoglycemia, respiratory distress, and neonatal jaundice were associated with increased risk of autistic disorders for term but not preterm infants. CONCLUSION: The increased risk of autistic disorders related to preterm birth is mediated primarily by prenatal and neonatal complications that occur more commonly among preterm infants. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/19841112/Can_association_between_preterm_birth_and_autism_be_explained_by_maternal_or_neonatal_morbidity L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=19841112 DB - PRIME DP - Unbound Medicine ER -