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NICU Survivors May See Higher Autism Rates

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AUSTIN, Texas -- Autism spectrum disorder (ASD) incidence was significantly higher in babies who spent time in the neonatal intensive care unit, versus the general population, and was often accompanied by comorbidities, researchers said here.

Out of 180 full-term babies admitted to the NICU, 6.7% were later diagnosed with ASD, a rate 16 to 67 times higher than that among the general population. In addition, 75% of them also had global developmental delays (GDD), epilepsy, and/or cerebral palsy, reported , of McGill University in Montreal, and colleagues at the annual meeting of the Child Neurology Society.

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  • Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.

"There were no specific risk factors that were attributed to the development of autism, but generally speaking, the children had quite a rough time early in life," study co-author Alexander Winkler-Schwartz, a medical student at McGill, told 51˶.

"For kids that are coming out of the NICU, there's something either about the insults or the circumstances that put them there, that makes them more at risk for developing autism than the general population," he added.

The researchers looked at the charts of 180 full-term births, 37 weeks of gestation or longer, born from 1992 to 2007 that had been in the NICU at Montreal Children's Hospital.

Among the patients, 40% were deemed normal, 43% were later diagnosed with GDD, 29% developed cerebral palsy, 26% had epilepsy, and 6.7% were diagnosed with ASD.

Of the 12 patients with ASD, nine also had at least one of the other disorders: 75% had GDD, 30% had epilepsy, and 30% had cerebral palsy. Only three of the patients with ASD were girls.

Emergency cesarean section were necessary for seven of the ASD patients, and eight of the patients experienced fetal distress.

After delivery, six babies received meconium staining, and two had meconium aspiration, while seven had at least a bag-mask, and four had endotracheal intubation with positive pressure ventilation. At discharge, eight infants were sent home with anti-epileptic drugs including phenobarbital.

The root cause for NICU admission in six of the babies was hypoxic ischemic encephalopathy. Among the other babies sent to the NICU, the root causes were genetics, infection or operation, and intracranial hemorrhage.

"Big picture: If you have a child in front of you that had an admission into the NICU -- had a bit of a rough time -- and has a comorbid diagnosis like cerebral palsy, epilepsy, and/or GDD, just consider that this group may be a little bit predisposed to developing autism later on," Winkler-Schwartz said. "If these criteria of NICU admission and comorbid diagnosis are met, it might be [a good indication] to institute a screening."

Disclosures

The authors declared no conflicts of interest.

Primary Source

Child Neurology Society

Shevell MI, et al "Autism spectrum disorder in a term birth NICU population" CNS 2013; Abstract 56.