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Infants born late/moderately preterm are at increased risk for a positive autism screen at 2 years of age

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Guy, Alexa, Seaton, Sarah E., Boyle, Elaine M., Draper, Elizabeth S., Field, David J. (David John), Manktelow, Bradley N., Marlow, Neil, Smith, Lucy K. and Johnson, Samantha J. (2015) Infants born late/moderately preterm are at increased risk for a positive autism screen at 2 years of age. The Journal of Pediatrics, Volume 166 (Number 2). pp. 269-275. doi:10.1016/j.jpeds.2014.10.053

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Official URL: http://dx.doi.org/10.1016/j.jpeds.2014.10.053

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Abstract

Objectives:
To assess the prevalence of positive screens using the Modified Checklist for Autism in Toddlers (M-CHAT) questionnaire and follow-up interview in late and moderately preterm (LMPT; 32-36 weeks) infants and term-born controls.

Study design:
Population-based prospective cohort study of 1130 LMPT and 1255 term-born infants. Parents completed the M-CHAT questionnaire at 2-years corrected age. Parents of infants with positive questionnaire screens were followed up with a telephone interview to clarify failed items. The M-CHAT questionnaire was re-scored, and infants were classified as true or false positives. Neurosensory, cognitive, and behavioral outcomes were assessed using parent report.

Results:
Parents of 634 (57%) LMPT and 761 (62%) term-born infants completed the M-CHAT questionnaire. LMPT infants had significantly higher risk of a positive questionnaire screen compared with controls (14.5% vs 9.2%; relative risk [RR] 1.58; 95% CI 1.18, 2.11). After follow-up, significantly more LMPT infants than controls had a true positive screen (2.4% vs 0.5%; RR 4.52; 1.51, 13.56). This remained significant after excluding infants with neurosensory impairments (2.0% vs 0.5%; RR 3.67; 1.19, 11.3).

Conclusions:
LMPT infants are at significantly increased risk for positive autistic screen. An M-CHAT follow-up interview is essential as screening for autism spectrum disorders is especially confounded in preterm populations. Infants with false positive screens are at risk for cognitive and behavioral problems.

Item Type: Journal Article
Subjects: R Medicine > RJ Pediatrics
Divisions: Faculty of Science > Psychology
Library of Congress Subject Headings (LCSH): Premature infants, Autism in children
Journal or Publication Title: The Journal of Pediatrics
Publisher: Mosby, Inc.
ISSN: 0022-3476
Official Date: February 2015
Dates:
DateEvent
February 2015Published
2 December 2014Available
22 October 2014Accepted
30 July 2014Submitted
Volume: Volume 166
Number: Number 2
Page Range: pp. 269-275
DOI: 10.1016/j.jpeds.2014.10.053
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access
Funder: National Institute for Health Research (Great Britain) (NIHR)
Grant number: RP-PG-0407-10029 (NIHR)

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