title: Autism spectrum disorder is associated with ventricular enlargement in a low birth weight population.
abstract: OBJECTIVE
  To determine the relation of neonatal cranial ultrasound abnormalities to autism spectrum disorders (ASD) in low birth weight (LBW) adult survivors, a population at increased ASD risk.
  
  
  METHODS
  This is a secondary analysis of a prospectively-followed regional birth cohort of 1105 LBW infants systematically screened for perinatal brain injury with cranial ultrasound in the first week of life and later assessed for ASD using a two-stage process [screening at age 16 years (n = 623) followed by diagnostic assessment at age 21 years of a systematically selected subgroup of those screened (n = 189)]; 14 cases of ASD were identified. For this analysis, cranial ultrasound abnormalities were defined as ventricular enlargement (indicative of diffuse white matter injury), parenchymal lesions (indicative of focal white matter injury), and isolated germinal matrix/intraventricular hemorrhage.
  
  
  RESULTS
  Compared with no cranial ultrasound abnormalities, any type of white matter injury (ventricular enlargement and/or parenchymal lesion) tripled the risk for screening positively for ASD [3.0 (2.2, 4.1)]. However, the risk of being diagnosed with ASD depended on type of white matter injury. With ventricular enlargement, the risk of ASD diagnosis was almost seven-fold that of no cranial ultrasound abnormality [6.7 (2.3, 19.7)], and no elevated risk was found for parenchymal lesion without ventricular enlargement [1.8 (0.2, 13.6)]. Isolated germinal matrix/intraventricular hemorrhage did not increase risk for a positive ASD screen or diagnosis.
  
  
  CONCLUSIONS
  In LBW neonates, cranial ultrasound evidence of ventricular enlargement is a strong and significant risk factor for subsequent development of rigorously-diagnosed ASD.
authors: Midland County Department of Public Health, Midland, MI 48640, USA. tmovsas@gmail.com
authors: Tammy Z
authors: TZ
authors: Movsas
authors: Jennifer A
authors: JA
authors: Pinto-Martin
authors: Agnes H
authors: AH
authors: Whitaker
authors: Judith F
authors: JF
authors: Feldman
authors: John M
authors: JM
authors: Lorenz
authors: Steven J
authors: SJ
authors: Korzeniewski
authors: Susan E
authors: SE
authors: Levy
authors: Nigel
authors: N
authors: Paneth
mesh_terms: D000293:Adolescent; D002552:Cerebral Ventricles / Q000000981:diagnostic imaging* / Q000473:pathology*; D002659:Child Development Disorders, Pervasive / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D014463:Ultrasonography; D055815:Young Adult