Meeting paperSMFM paperAutism risk in small- and large-for-gestational-age infants
Section snippets
Materials and Methods
This was a population-based cohort study, approved by the California Protection of Human Subjects Committee; the Office of Statewide Health Planning and Development (OSHPD); and the University of California, Davis Human Subjects Committee.
We utilized a database constructed by our group in 2007 to evaluate perinatal risk factors for developmental disabilities. An 11-year birth cohort (Jan. 1, 1991, through Dec. 31, 2001) was identified within a database provided by the California OSHPD, which
Results
Within the cohort of 5,979,605 children born in California from 1991 through 2001, 21,717 children with autism were identified. The remainder of the birth cohort served as the control group (n = 5,957,888). Male sex, advanced maternal and paternal ages, Asian race, chronic hypertension, preeclampsia, any form of diabetes, high birth order (≥3), short interpregnancy interval, and twin gestations were significantly associated with autism (Table 2).
Within the entire population, autism risk was
Comment
Our large birth-cohort analysis describes autism risk by BW percentile, stratified by GA at birth. Within the entire cohort, both SGA and LGA BW were associated with autism. Stratification by GA revealed that only preterm SGA infants (<34 weeks) and term LGA infants (39-41 weeks) had a significantly increased risk for autism, while preterm LGA infants (<32 weeks) were protected against autism.
The strengths of this analysis lie primarily in the large number of children with autism diagnosed
Conclusion
Autism risk is significantly increased at both extremes of BW appropriateness. Stratification by GA yielded a more complex relationship, with increased risk seen only in preterm SGA infants and term LGA infants. Unexpectedly, LGA BW correlated with a significantly lower autism risk in children born <32 weeks. The nature of the associations between SGA and LGA BW and autism risk remains uncertain. We hope to further investigate perinatal conditions surrounding term delivery of LGA infants, and
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Cited by (0)
Supported in part by National Institutes of Health grant number R03-HD050575.
The authors report no conflict of interest.
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Cite this article as: Moore GS, Kneitel AW, Walker CK, et al. Autism risk in small- and large-for-gestational-age infants. Am J Obstet Gynecol 2012;206:314.e1-9.