title: Infants born late/moderately preterm are at increased risk for a positive autism screen at 2 years of age.
abstract: OBJECTIVE
  To assess the prevalence of positive screens using the Modified Checklist for Autism in Toddlers (M-CHAT) questionnaire and follow-up interview in late and moderately preterm (LMPT; 32-36 weeks) infants and term-born controls.
  
  
  METHODS
  Population-based prospective cohort study of 1130 LMPT and 1255 term-born infants. Parents completed the M-CHAT questionnaire at 2-years corrected age. Parents of infants with positive questionnaire screens were followed up with a telephone interview to clarify failed items. The M-CHAT questionnaire was re-scored, and infants were classified as true or false positives. Neurosensory, cognitive, and behavioral outcomes were assessed using parent report.
  
  
  RESULTS
  Parents of 634 (57%) LMPT and 761 (62%) term-born infants completed the M-CHAT questionnaire. LMPT infants had significantly higher risk of a positive questionnaire screen compared with controls (14.5% vs 9.2%; relative risk [RR] 1.58; 95% CI 1.18, 2.11). After follow-up, significantly more LMPT infants than controls had a true positive screen (2.4% vs 0.5%; RR 4.52; 1.51, 13.56). This remained significant after excluding infants with neurosensory impairments (2.0% vs 0.5%; RR 3.67; 1.19, 11.3).
  
  
  CONCLUSIONS
  LMPT infants are at significantly increased risk for positive autistic screen. An M-CHAT follow-up interview is essential as screening for autism spectrum disorders is especially confounded in preterm populations. Infants with false positive screens are at risk for cognitive and behavioral problems.
authors.affiliation: Department of Health Sciences, University of Leicester, Leicester, United Kingdom; School of Psychology, University of Warwick, Coventry, United Kingdom.
authors.forename: Alexa
authors.initials: A
authors.lastname: Guy
authors.affiliation: Department of Health Sciences, University of Leicester, Leicester, United Kingdom.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Seaton
authors.affiliation: Department of Health Sciences, University of Leicester, Leicester, United Kingdom.
authors.forename: Elaine M
authors.initials: EM
authors.lastname: Boyle
authors.affiliation: Department of Health Sciences, University of Leicester, Leicester, United Kingdom.
authors.forename: Elizabeth S
authors.initials: ES
authors.lastname: Draper
authors.affiliation: Department of Health Sciences, University of Leicester, Leicester, United Kingdom.
authors.forename: David J
authors.initials: DJ
authors.lastname: Field
authors.affiliation: Department of Health Sciences, University of Leicester, Leicester, United Kingdom.
authors.forename: Bradley N
authors.initials: BN
authors.lastname: Manktelow
authors.affiliation: Department of Academic Neonatology, Institute for Women's Health, University College London, London, United Kingdom.
authors.forename: Neil
authors.initials: N
authors.lastname: Marlow
authors.affiliation: Department of Health Sciences, University of Leicester, Leicester, United Kingdom.
authors.forename: Lucy K
authors.initials: LK
authors.lastname: Smith
authors.affiliation: Department of Health Sciences, University of Leicester, Leicester, United Kingdom. Electronic address: sjj19@le.ac.uk.
authors.forename: Samantha
authors.initials: S
authors.lastname: Johnson
mesh_terms: D001321:Autistic Disorder / Q000175:diagnosis*; D057189:Checklist; D002675:Child, Preschool; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000175:diagnosis*; D008297:Male; D011446:Prospective Studies; D018570:Risk Assessment; D011795:Surveys and Questionnaires