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

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.