The Association Between Preterm Birth and the Risk of Autism Spectrum Disorder: A Systematic Review
Bibliographic record
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental condition with a complex etiology involving genetic and environmental factors. Preterm birth, a significant global health issue, has been frequently identified as a potential risk factor, but a comprehensive synthesis of the evidence is needed. This systematic review aimed to evaluate and synthesize the current evidence on the association between preterm birth and the risk of ASD. The review was conducted following the PRISMA guidelines. A systematic search of PubMed, Web of Science, SCOPUS, and Science Direct was performed. Two independent reviewers screened titles, abstracts, and full-text articles. Observational studies investigating the association between preterm birth and ASD were included. Data were extracted using a standardized form, and the risk of bias was assessed using the Newcastle-Ottawa Scale. Results demonstrated a significant association between preterm birth and an increased risk of ASD, characterized by a strong dose-response relationship where risk escalates with decreasing gestational age. For instance, one large cohort study reported adjusted prevalence rate of 3.72 for boys born extremely preterm. This association was largely independent of shared genetic and environmental factors, as shown in co-sibling analyses. Studies reported alarmingly high ASD prevalence rates, up to 20.8%, in very preterm cohorts. Preterm birth is a major, independent risk factor for ASD, with a clear inverse relationship between gestational age and risk. The findings underscore the critical need for systematic developmental surveillance and early ASD screening in preterm populations. Future research should focus on elucidating the underlying neurobiological mechanisms to inform targeted interventions.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.026 | 0.064 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.002 |
| Science and technology studies | 0.003 | 0.003 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.003 | 0.001 |
| Research integrity | 0.000 | 0.005 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".