The Epidemiology of Autism in a Low Birthweight Cohort

描述（由申请人提供）：本研究的目的是更好地描述低出生体重（LBW）幸存者的自闭症谱系障碍（ASD）和社会沟通问题，并更好地了解产前、产后和新生儿并发症之间的关系，包括ASD脑损伤和该人群的社会和沟通问题。研究样本将从新生儿脑出血研究（NBHS）队列中抽取，NBHS队列是迄今为止使用连续颅超声（US）筛选的最大区域性LBW队列。在15-16岁时重新评估该队列，并获得关于ASD筛查的父母报告（社交问卷和自闭症筛查问卷）。我们建议对所有ASD筛查阳性的参与者和筛查阴性的参与者进行严格的诊断评估。根据这一目标的具体目标是：（1）估计这一低出生体重人群目前的ASD患病率，并将这一患病率与普通人群研究报告的患病率进行比较;（2）基于ASD筛查状态，系统地描述和比较ASD诊断阳性者的现象学和发育史这些患者包括ASD筛查阳性但ASD诊断不阳性的患者（ASD假阳性）、ASD筛查阴性但ASD诊断评估阴性的青少年患者（对照）。所描述和比较的域将包括ASD中受影响的两个核心域（社交、沟通和兴趣）和相关功能（认知、运动功能、适应行为、轻微身体异常）（3）使用从原始NBHS研究可获得的广泛的一组特定的产前、产后和新生儿并发症来检查ASD真阳性的预测因子和单独的ASD假阳性的预测因子;包括母亲感染指数和白色物质损伤的头颅US证据（4）以检查精神障碍的家庭负荷与ASD真阳性状态和ASD假阳性状态的关系，（5）对于该LBW人群，评估SCQ和ASSQ对ASD真阳性、ASD假阳性和对照的筛查特性。该应用程序有可能产生关于ASD和LBW幸存者的社会和沟通问题的重要信息。除了描述ASD在LBW幸存者中的患病率和表现外，还将阐明可能为ASD的预防和治疗以及普通人群中的社会和沟通问题提供信息的病因机制。

DESCRIPTION (provided by applicant): The goals of this study are to better characterize Autistic Spectrum Disorders (ASD) and social communication problems in low birthweight (LBW) survivors and to better understand the relation between pre, peri and neonatal complications, including brain injury to ASD and social and communication problems in this population. The study sample will be drawn from the Neonatal Brain Hemorrhage Study (NBHS) cohort, the largest regional LBW cohort screened with serial cranial ultrasound (US) ever to be assembled. The cohort was re-assessed at age 15-16 and parent report on screens for ASD (Social Communication Questionnaire and the Asperger Syndrome Screening Questionnaire) was obtained. We propose to rigorously evaluate for diagnosis all participants who screened positive for ASD and a sample of those who screened negative. The specific aims pursuant to this goal are: (1) to estimate, for this LBW population, the current prevalence of ASD and to compare this prevalence to those reported in general populations studies; (2) to systematically describe and compare, based on ASD screening status, the phenomenology and developmental history of those positive for an ASD diagnosis (ASD True Positives), those positive on the ASD screen but not diagnostically positive for ASD (ASD False Positives) and those who were negative on the ASD screen as adolescents and negative for ASD upon diagnostic evaluation as well (Controls). The domains described and compared will include both the core domains affected in ASD (social interaction, communication and interests) and associated features (cognition, motor function, adaptive behavior, minor physical anomalies) (3) to examine predictors of ASD true positives and separately, predictors of ASD false positives using the extensive set of specific pre-, peri- and neonatal complications available from the original NBHS study; including indices of maternal infection and cranial US evidence of white matter injury (4) to examine the relation of family loading for psychiatric disorder to ASD true positive status and ASD false positives status, (5) to estimate, for this LBW population, the screening properties of the SCQ and the ASSQ for ASD true positives, ASD false positives and controls. This application has the potential to yield important information about ASD and social and communication problems in LBW survivors. In addition to describing the prevalence and presentation of ASD in LBW survivors, it will elucidate etiologic mechanisms that may inform prevention and treatment of ASD and social and communication problems in the general population.