Early autism risk factors: a cohort study of children born very preterm at 5-years.

OBJECTIVE: Explore the association of prenatal, perinatal, and postnatal risk factors with autism risk at 5-years corrected age in very preterm (VPT) children. STUDY DESIGN: Data from a longitudinal cohort study of 315 VPT and 172 term-born children at a US-based academic medical center were analyzed, exploring antecedents of autism risk using elastic net regression. RESULTS: More children born VPT (8.9%) had a Social Communication Questionnaire score associated with autism (i.e., SCQ ≥ 15) than term-born controls (2.9%; p = 0.012). For VPT children, cerebellar abnormalities at term-equivalent age (OR = 1.339, 95% CI = 1.010-1.778) and moderate-severe histologic chorioamnionitis (OR = 4.148, CI = 1.294-13.368) were significantly associated with autism risk, in addition to male sex and social risk. VPT children with SCQ ≥ 15 had poorer adaptive, behavioral, cognitive, and executive functioning (all ps < 0.001). CONCLUSION: Early screening for children with these risk factors can facilitate early intervention for those at most risk for poorer neurodevelopmental outcomes.