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Neuropediatrics 2021; 52(04): 284-293
DOI: 10.1055/s-0041-1726401
Original Article

Potential Risk Factors for Autism in Children Requiring Neonatal Intensive Care Unit

Marília Barbosa de Matos
1   Department of Neuropediatrics, Children's Hospital Pequeno Príncipe, Waldemar Monastier Hospital, Curitiba, Brazil
2   Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba, Brazil
3   Faculdades Pequeno Príncipe, Curitiba, Brazil
,
Tiago S. Bara
2   Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba, Brazil
3   Faculdades Pequeno Príncipe, Curitiba, Brazil
,
Érico P. G. Felden
4   Department of Health Sciences, Santa Catarina State University UDESC, Florianópolis, Brazil
,
Mara L. Cordeiro 
2   Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba, Brazil
3   Faculdades Pequeno Príncipe, Curitiba, Brazil
5   Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California, United States
› Author Affiliations Funding This study was funded in part by a Secretaria Ciência e Tecnologia e Ensino Superior do Estado do Parana grant (Conv#007/14) to M.L.C. and a grant from Coordenação de Aperfeiçoamento de Pessoal de Nivel Superior (CAPES), Brazil to M.B.dM. and T.S.B.—Finance Code 001.
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Abstract

Background The etiology of autism spectrum disorder (ASD) is complex and involves the interplay of genetic and environmental factors.

Aim We sought to identify potential prenatal, perinatal, and neonatal risk factors for ASD in a unique population of children who had perinatal complications and required care in a neonatal intensive care unit (NICU).

Methods This prospective cohort study included 73 patients discharged from a NICU who received long-term follow-up at the largest children's hospital in Brazil. Potential risk factors were compared between 44 children with a diagnosis of ASD and 29 children without using the Mann–Whitney U test. Proportions were analyzed using the chi-square test. Simple and multiple logistic regression tests were performed.

Results Of 38 factors analyzed, the following 7 were associated with ASD: family history of neuropsychiatric disorders (p = 0.049); maternal psychological distress during pregnancy (p = 0.007); ≥ 26 days in the NICU (p = 0.001); feeding tube for ≥ 15 days (p = 0.014); retinopathy of prematurity (p = 0.022); use of three or more antibiotics (p = 0.008); and co-sleeping until up to 2 years of age (p = 0.004).

Conclusion This study found associations between specific risk factors during critical neurodevelopmental periods and a subsequent diagnosis of ASD. Knowledge of the etiologic factors that may influence the development for ASD is paramount for the development of intervention strategies and improvement of prognoses.

Keywords

autism - Brazil - intensive care - neonatal - risk factors

Data Availability

Data are available upon request.


Authors' contribution

M.B.dM. and M.L.C. designed the study. M.B.dM. collected all data and was responsible for the participating patients. T.S.B. and E.P.G.F. performed the statistical analyses. All authors contributed with relevant literature, data analysis, and interpretation of the results. All authors contributed to drafting of the manuscript, approved the final version of the manuscript, and agree to be accountable for all aspects of the work. M.L.C. coordinated the study, and revised and conducted critical reviews of the manuscript for key intellectual content.




Publication History

Received: 28 September 2020

Accepted: 08 February 2021

Article published online:
14 April 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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