A high prevalence of autism spectrum disorder is reported in children born extremely preterm (EP), but an even larger proportion of survivors are affected by subclinical difficulties than meet diagnostic criteria. The aims of this study were to investigate autistic traits associated with the broader autism phenotype in a cohort of young adults born EP, and explore how these traits relate to emotion recognition, empathy and autism symptom presentation in childhood. The prevalence of autism diagnoses was also investigated. One hundred and twenty-nine young adults born before 26 weeks of gestation and 65 term-born controls participated in the 19-year follow-up phase of the EPICure studies. In addition to a clinical interview, participants completed the Broader Autism Phenotype Questionnaire (BAPQ), the Empathy Quotient questionnaire, and the Frankfurt Test and Training of Facial Affect Recognition. The Social Communication Questionnaire (SCQ) was completed by the participants’ parents at age 11 years. EP born young adults scored significantly higher on the BAPQ in comparison with their term-born peers, indicating greater autistic traits. Among EP participants, BAPQ scores were correlated with SCQ scores in childhood (r = 0.484, p < 0.001). EP young adults had significantly lower scores in emotion recognition and empathy in comparison with controls; however, this effect was mediated by IQ. At 19 years, a diagnosis of autism was reported by 10% of EP participants versus 1.6% of controls, whereas 31% of EP participants scored above the cut-off for the broader autism phenotype in comparison with 8.5% of term-born controls. The high attrition of EP participants from lower socio-economic backgrounds and with lower cognitive functioning may have led to an underrepresentation of those presenting with difficulties associated with autism. A larger proportion of EP survivors are affected by difficulties associated with autism than have confirmed diagnoses, with a moderate correlation between autism symptom scores in childhood and autistic traits in young adulthood. EP young adults had significantly higher autism symptom scores and a larger proportion had a diagnosis of autism than controls. Screening for autistic traits at set points throughout childhood will help identify those EP individuals at risk of social difficulties who may benefit from intervention.

中文翻译：

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青年期极早产和自闭症特征：EPICure 研究

据报道，自闭症谱系障碍在极早产 (EP) 出生的儿童中的患病率很高，但更大比例的幸存者受到亚临床困难的影响超过了诊断标准。本研究的目的是调查一组出生为 EP 的年轻人中与更广泛的自闭症表型相关的自闭症特征，并探索这些特征如何与儿童时期的情绪识别、同理心和自闭症症状表现相关。还调查了自闭症诊断的患病率。129 名在妊娠 26 周前出生的年轻人和 65 名足月出生的对照组参与了 EPICure 研究的 19 年随访阶段。除了临床访谈外，参与者还完成了更广泛的自闭症表型问卷 (BAPQ)、移情商问卷、以及面部情感识别的法兰克福测试和培训。社会沟通问卷 (SCQ) 由参与者的父母在 11 岁时完成。与足月出生的同龄人相比，EP 出生的年轻人在 BAPQ 上的得分明显更高，表明自闭症特征更大。在 EP 参与者中，BAPQ 分数与儿童时期的 SCQ 分数相关（r = 0.484，p < 0.001）。与对照组相比，EP 青年人的情绪识别和同理心得分显着降低；然而，这种影响是由智商介导的。在 19 岁时，10% 的 EP 参与者报告了自闭症的诊断，而对照组为 1.6%，而 31% 的 EP 参与者在更广泛的自闭症表型中得分高于临界值，而足月出生的对照组为 8.5%。来自较低社会经济背景和较低认知功能的 EP 参与者的高流失率可能导致那些出现自闭症相关困难的人的代表性不足。与确诊诊断相比，更大比例的 EP 幸存者受到与自闭症相关困难的影响，儿童期自闭症症状评分与青年期自闭症特征之间存在中度相关性。与对照组相比，EP 年轻人的自闭症症状评分显着更高，并且被诊断为自闭症的比例更大。在整个童年时期的设定点筛查自闭症特征将有助于识别那些可能从干预中受益的有社交困难风险的 EP 个体。