Purpose Autism is more common among children born preterm than term. This study determined the prevalence of positive autism screening among 18-30 month old preterm-born children and evaluated sociodemographic, clinical, and neurodevelopmental factors associated with positive screens.

Methods Secondary analyses of Stanford data from California Perinatal Quality Care Collaborative. Infants born < 32 weeks gestation between 2016-2020, who attended High-Risk Infant Follow-Up at 18-30 months, were classified into two groups based on results of Modified Checklist for Autism in Toddlers-Revised with Follow-Up (M-CHAT-R/F): positive-screen (score > 2) and negative-screen (≤ 2). We compared sociodemographics, clinical factors, and language development across groups.

Results Prevalence of positive-screens was 12.2% (41/337). Children in the positive-screen group had lower gestational age, birthweight and longer hospital stays than children in the negative-screen group (all p < .05); gestational age was the primary factor associated with a positive screen (OR 0.75, 0.56-0.99). We found no group differences in sociodemographics or medical complications; children in the positive-screen group had lower language scores than children in the negative-screen group (p < .001). All children in the positive-screen group and ~⅓ of children in the negative-screen group scored low in language.

Conclusion The high prevalence of positive-screens reinforces the importance of early screening for autism in very preterm children. Gestational age at birth was the only factor associated with positive-screens. Language difficulties were not specific to children with positive-screens, highlighting the need for autism screening and routine developmental assessments for preterm children.

The authors have declared no competing interest.

This research work was supported by grants from the National Institutes of Health-Eunice Kennedy Shriver National Institute of Child Health and Human Development (HM Feldman, PI; 2RO1- HD069150) and National Medical Research Council, Singapore (R Aishworiya, PI Transition Award (MOH-001579)).

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethics Committee/IRB of Stanford University gave ethical approval for this work.

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All data produced in the present study are available upon reasonable request to the authors.

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