Early Screening for Autism Spectrum Disorder in Ex-preterm Infants: A Tunisia Prospective Survey
Ben Touhemi Donia1,4*, Khemakehem Khaoula1,4, Majdoub Yosra2,4, Hadjkacem Imen1,4, Boudabous Jaweher1,4, Hamida Nedia3,4, Ayadi Hela1,4 and Moalla Yousr1,4
1Department of Child and Adolescent Psychiatry in the University Hospital HediChaker. Sfax, Tunisia
2Department of Preventive Medicine in the University Hospital HediChaker. Sfax, Tunisia
3Department of Neonatology in the University Hospital HediChaker. Sfax, Tunisia
4Faculty of Medicine of Sfax, Tunisia
*Corresponding Author: Ben Touhemi Donia, Department of Child and Adolescent Psychiatry in the University Hospital HediChaker. Sfax, Faculty of Medicine of Sfax, Tunisia.
July 31, 2021 ; Published: December 31, 2021
Purpose: The aim of the study was to screen autism spectrum disorder (ASD) in preterm children (born before 37 weeks of gestation). The study also aimed to identify maternal and neonatal risk factors associated with a positive screen.
Method: Sixty-four ex-preterm children were recruited for a two-round examination at the age of 18 and 24 months. All children were accompanied by one of their parents. The consultation included a psychiatric interview and mainly the filling of the Modified Checklist for Autism in Toddlers (M- CHAT) scale.
Results: Thirteen (20.3%) of the 64 Ex-preterm children were screened positive on the M-CHAT at 18 months compared to six (11.76%) of the 51 infants who were re-examined at 24 months. The follow-up interview revealed that three of the preterm children were diagnosed with autism based on the DSM 5 criteria. The positive screened preterm children were born after 32 weeks of gestation and displayed higher incidence of pathological fetal heart rate. In addition, chorioamniotitis was significantly associated with positive autism screening. Multivariable analysis showed that only pathological fetal heart rate was independently associated with M-CHAT-positive screen (odds ratio 9.25, p=0.02, 95% confidence interval 51.3-62.09).
Conclusions: Our study as well as literature studies provide evidence that prematurity increases the risk of ASD. A pathological fetal heart rate and chorioamniotitis were significantly associated with positive autism screening. The nature of the associations between prematurity and this risk remains unclear.
Keywords: Autism Spectrum Disorder; Prematurity; Screening; Risk Factors
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