Extremely low gestational age and very low birth weight for GA are risk factors for ASD in a large cohort study of 10-year-old children born at 23-27 weeks gestation

Robert M Joseph, Steven J Korzeniewski, Elizabeth N Allred, T Michael O’Shea, Tim Heeren, Jean A Frazier, Janice Ware, Deborah Hirtz, Alan Leviton, Karl Kuban, ELGAN Study Investigators

Am J Obstet Gynecol. 2016 Nov 12. pii: S0002-9378(16)31989-5

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857 assessed for ASD; of these, 840 (98%) assessed for ID. ASD+/ID- diagnosed in 3.2% (27/840), ASD+/ID+ in 3.8% (32/840), and ASD-/ID+ in 8.5% (71/840). Maternal report of cervical-vaginal ‘infection’ during pregnancy associated with risk of ASD+/ID+ (odd ratio [OR], 2.7). lowest GA category (23-24 weeks) associated with increased risk of ASD+/ID+ (OR, 2.9) and ASD+/ID- (OR, 4.4). Severe FGR strongly associated with increased risk for ASD+/ID- (OR, 9.9), peripartum maternal fever uniquely associated with risk of ASD-/ID+ (OR, 2.9). confirms low GA associated with risk for ASD irrespective of intellectual ability, whereas severe FGR strongly associated with ASD without ID. Cervical-vaginal infection associated with risk of ASD with ID, and peripartum maternal fever associated with risk for ID without ASD.