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表征低出生体重（LBW）幸存者的自闭症谱系障碍（ASD）和社会沟通问题，并更好地了解该人群中ASD脑损伤和社会沟通问题的产前、围生期和新生儿并发症之间的关系。研究样本将来自新生儿脑出血研究（NBHS）队列，这是迄今为止使用连续颅超声（US）筛查的最大的区域性LBW队列。在15-16岁时对队列进行重新评估，并获得家长的ASD筛查报告（社会沟通问卷和阿斯伯格综合征筛查问卷）。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的是：(1)估计LBW人群目前的ASD患病率，并将这一患病率与一般人群研究报告的患病率进行比较；(2)根据ASD筛查情况，系统描述和比较ASD诊断阳性（真阳性）、ASD筛查阳性但未诊断为阳性（假阳性）和ASD筛查阴性且诊断评估为阴性的青少年（对照组）的现象学和发展史。描述和比较的领域将包括受ASD影响的核心领域（社会互动，沟通和兴趣）和相关特征（认知，运动功能，适应行为，轻微的身体异常）。(3)检查ASD真阳性的预测因素，并单独使用从原始NBHS研究中获得的广泛的特定前，围期和新生儿并发症来预测ASD假阳性；(4)研究精神障碍家庭负荷与ASD真阳性和假阳性状态的关系；(5)评估LBW人群中SCQ和ASSQ对ASD真阳性、ASD假阳性和对照的筛查特性。这个应用程序有可能产生关于自闭症和LBW幸存者的社会和沟通问题的重要信息。除了描述LBW幸存者中ASD的患病率和表现外，它还将阐明病因机制，为预防和治疗ASD以及普通人群的社会和沟通问题提供信息。

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.