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

Badawi, Nadia; Dixon, Glenys; Felix, Janine F.; Keogh, John; Petterson, Beverly; Stanley, Fiona; Kurinczuk, Jennifer J

doi:10.1017/s001216220600020x

Cited by 63 publications

(32 citation statements)

References 32 publications

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“…72,[146][147][148][149][150][151][152] A significant association between term newborn encephalopathy and children later diagnosed with ASD was reported recently. 72,150 Badawi et al 150 reported that 5% of survivors of newborn encephalopathy were diagnosed with an ASD, which represented an almost sixfold increase compared with matched controls. This increase may represent a genetically derived predisposition (which makes the infants vulnerable to both encephalopathy and ASD) or an independent mechanism.…”

Section: Perinatal Periodmentioning

confidence: 85%

Identification and Evaluation of Children With Autism Spectrum Disorders

Johnson

Myers²

2007

Pediatrics

1,679

1,038

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Autism spectrum disorders are not rare; many primary care pediatricians care for several children with autism spectrum disorders. Pediatricians play an important role in early recognition of autism spectrum disorders, because they usually are the first point of contact for parents. Parents are now much more aware of the early signs of autism spectrum disorders because of frequent coverage in the media; if their child demonstrates any of the published signs, they will most likely raise their concerns to their child's pediatrician. It is important that pediatricians be able to recognize the signs and symptoms of autism spectrum disorders and have a strategy for assessing them systematically. Pediatricians also must be aware of local resources that can assist in making a definitive diagnosis of, and in managing, autism spectrum disorders. The pediatrician must be familiar with developmental, educational, and community resources as well as medical subspecialty clinics. This clinical report is 1 of 2 documents that replace the original American Academy of Pediatrics policy statement and technical report published in 2001. This report addresses background information, including definition, history, epidemiology, diagnostic criteria, early signs, neuropathologic aspects, and etiologic possibilities in autism spectrum disorders. In addition, this report provides an algorithm to help the pediatrician develop a strategy for early identification of children with autism spectrum disorders. The accompanying clinical report addresses the management of children with autism spectrum disorders and follows this report on page 1162 [available at www.pediatrics.org/cgi/content/full/120/5/1162]. Both clinical reports are complemented by the toolkit titled “Autism: Caring for Children With Autism Spectrum Disorders: A Resource Toolkit for Clinicians,” which contains screening and surveillance tools, practical forms, tables, and parent handouts to assist the pediatrician in the identification, evaluation, and management of autism spectrum disorders in children.

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Section: Perinatal Periodmentioning

confidence: 85%

Identification and Evaluation of Children With Autism Spectrum Disorders

Johnson

Myers²

2007

Pediatrics

1,679

1,038

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“…A mildly abnormal outcome was determined if 1 or 2 subscales scored ≤ 85 but >70, and a moderately abnormal outcome if all 3 scored ≤ 85 but >70. Infants were deemed to have a severely abnormal outcome if they scored ≤ 70 in all subscales, or suffered dyskinetic or spastic quadriplegic cerebral palsy or autism, or if they died [2,21,22] .…”

Section: Methodsmentioning

confidence: 99%

Cord Blood IL-16 Is Associated with 3-Year Neurodevelopmental Outcomes in Perinatal Asphyxia and Hypoxic-Ischaemic Encephalopathy

Ahearne¹,

Chang

Walsh

et al. 2017

Dev Neurosci

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Activation of the inflammatory pathway is increasingly recognized as an important mechanism of injury following neonatal asphyxia and encephalopathy. This process may contribute to the poor prognosis seen in some cases, despite therapeutic hypothermia. Our group has previously identified raised interleukin (IL)-6 and IL-16, measured in umbilical cord blood at birth, to be predictive of grade of hypoxic-ischaemic encephalopathy (HIE). Our aim in this study was to examine the ability of these cytokines to predict the 3-year neurodevelopmental outcome in the same cohort. As part of a prospective, longitudinal cohort study set in a single tertiary maternity unit, term infants with biochemical and clinical evidence of perinatal asphyxia were recruited at birth. Umbilical cord blood was collected and analyzed for IL-6 and IL-16 using a Luminex assay. The neurodevelopmental outcome of these infants was assessed at 3 years using the Bayley Scales of Infant and Toddler Development (Edition 3). Early cord blood measurement of IL-6 and IL-16 and long-term outcome were available in 33/69 infants. Median (IQR) IL-16 differentiated infants with a severely abnormal outcome (n = 6) compared to all others (n = 27), (646 [466-1,085] vs. 383.5 [284-494] pg/mL; p = 0.012). IL-16 levels were able to predict a severe outcome with an area under the receiver-operating characteristic (ROC) curve of 0.827 (95% CI 0.628-1.000; p = 0.014). Levels ≥514 pg/mL predicted a severe outcome with a sensitivity of 83% and a specificity of 81%. IL-16 also outperformed other routine biochemical markers available at birth for the prediction of severe outcome. APGAR scores at 1 and 10 min were also predictive of a severe outcome (p = 0.022 and p = 0.036, respectively). A combination of IL-16 with these clinical markers did not improve predictive value, but IL-16 combined with electroencephalogram grading increased the area under the ROC curve. IL-6 did not show any association with 3-year outcome. This is the first report studying the association of IL-16 measured at birth with long-term outcome in a cohort of neonates with perinatal asphyxia. IL-16 may be an early biomarker of severe injury and aid in the long-term prognostication in infants with HIE.

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“…2 However, although research of novel therapies for perinatal asphyxia is currently a priority, surprisingly little is known about its long-term social and economic consequences. In addition to its effects on IQ, there is some evidence that infants exposed to perinatal asphyxia have increased risks of psychiatric disease, 3 autism, 4 and behavioral and educational problems. 5 Despite these reported associations, the potential impact on long-term pragmatic measures of functioning are unknown.…”

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confidence: 99%