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Autism following a history of newborn encephalopathy: more than a coincidence?

Published online by Cambridge University Press:  17 January 2006

Nadia Badawi
Affiliation:
Department of Neonatology, The Children's Hospital at Westmead, University of Sydney, Sydney, Australia.
Glenys Dixon
Affiliation:
Telethon Institute for Child Health Research, Subiaco, Western Australia, Australia.
Janine F Felix
Affiliation:
Paediatric Surgical Intensive Care Unit, Erasmus MC – Sophia Children's Hospital, Rotterdam, the Netherlands.
John M Keogh
Affiliation:
Hornsby Ku-Ring Gai Hospital, University of Sydney, Sydney, Australia.
Beverly Petterson
Affiliation:
Telethon Institute for Child Health Research, Subiaco, Western Australia, Australia.
Fiona J Stanley
Affiliation:
Telethon Institute for Child Health Research, Subiaco, Western Australia, Australia.
Jennifer J Kurinczuk
Affiliation:
National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK.
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Abstract

Between June 1993 and December 1996, 276 term newborn infants with encephalopathy and 564 randomly selected term controls were enrolled in a population-based study of moderate and severe term newborn encephalopathy (NE) in Western Australia. During comprehensive neurobehavioural and cognitive follow-up of all patients and controls at 3 years and again at 5 years of age we found an unexpected but strong association between NE and autism spectrum disorders (ASDs). A diagnosis of ASD by age 5 years was reached using criteria according of the Diagnostic Statistical Manual, 4th edition. Linking records to the Western Australian Disability Services Commission Register ensured that no child in the study with ASD was missed. By age 5 years, 37 (13.4%) infants with NE and one (0.2%) control had died. Among the 239 survivors of NE, 12 (5%) were diagnosed with an ASD. Of these, 10 (4.2%) met the full criteria for autism, one had pervasive developmental disorder–not otherwise specified, and one had Asperger syndrome. Among the 563 surviving controls, five (0.8%) were diagnosed with an ASD: three with autism, one with autism/possible Asperger syndrome, and one with Asperger syndrome. Compared with the controls, the children who had experienced NE were 5.9 times (95% confidence interval 2.0–16.9) more likely to have been diagnosed with an ASD.

Type
Original Articles
Copyright
2006 Mac Keith Press

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