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Sociodemographic and neonatal factors associated with early childhood socialcommunication difficulties in children born preterm

Presented at the Neonatal Society 2012 Summer Meeting.

Wong HS1, Huertas-Ceballos A2, Cowan FM1, Modi N1 on behalf of the Medicines for Neonates Investigator Group

1 Section of Neonatal Medicine, Department of Medicine, Chelsea & Westminster campus, Imperial College London, UK
2 Neonatal Intensive Care Unit, University College London Hospital, UK

Background: The Quantitative Checklist for Autism in Toddlers (Q-CHAT) is a parent-completed questionnaire that provides a quantitative measure of early childhood social-communication difficulty (1). Q-CHAT scores can range between 0 and 100, with higher scores representing greater autistic traits. The Q-CHAT scores of children born preterm are higher than the general population (2). We aimed to determine sociodemographic and neonatal factors associated with social-communication difficulties, as measured by the Q-CHAT, in preterm children at 24 months corrected age. The study was approved by the Royal Free Hospital Research Ethics Committee (REC 10/H0720/35).

Methods: The parents of children born at <30 weeks gestation and enrolled in a study evaluating routinely collected neurodevelopmental data were asked to complete the Q-CHAT. Children with severe neurosensory disabilities and cerebral palsy were excluded. The effect of factors identified a priori (maternal age, gestation, birthweight z-score, gender, multiple pregnancy, length of mechanical ventilation, supplemental oxygen requirement at 36 weeks post-menstrual age and index of multiple deprivation (IMD)), on Q-CHAT scores were examined using univariable and multivariable linear regressions.

Results: The Q-CHAT was completed by the parents of 104 children (mean [SD] gestation 27.0 [1.7] weeks, when the children were at a mean corrected age of 24.7 [2.7] months). On univariable analyses, gestation, multiple pregnancy, supplemental oxygen requirement at 36 weeks post-menstrual age and IMD were positively associated with Q-CHAT scores. Low gestation (p=0.02) and higher IMD (p<0.01) were independently associated with higher Q-CHAT scores on multivariable analyses. The mean Q-CHAT score of children living in the most deprived quintile was 7.0 (95% CI 1.64 to 12.37) points higher than children living in the least deprived quintile (p=0.01).

Conclusion: Preterm birth is a recognised risk factor for autism spectrum disorder. We report a novel finding of high deprivation as an independent predictor of early childhood social-communication difficulty in the preterm population.

Corresponding author: h.wong@imperial.ac.uk

1. Allison C, et al. The Q-CHAT: a normally distributed quantitative measure of autistic traits at 18-24 months of age: a preliminary report. J Autism Dev Disord 2008;38:1414-25.
2. Wong HS, et al. Proceedings of the Neonatal Society 2012 Spring Meeting.

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