Infections in children with autism spectrum disorder: Study to Explore Early Development (SEED).
Katherine R Sabourin, Ann Reynolds, Diana Schendel and 7 others
PMID 30475448WHAT IT FOUND
Compared with typically developing children, children with autism were more likely to have infection in the neonatal period and first three years.
Compared with children with other developmental delays, only neonatal infection differed. This is an association, not proof of cause.
Key findings
01Compared with typically developing children, children with ASD were more likely to have an infection during the first three years and during the neonatal period, and were more likely to have neonatal hypothermia.
02Compared with children classified as having developmental delay without ASD characteristics, children with ASD were more likely to have a neonatal infection, but did not differ in caregiver-reported infections during the first three years or abnormal neonatal temperatures.
03Among children with ASD, those with regression were more likely to have had an infection during the first year of life; other infection exposures did not differ significantly.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study is observational, so it cannot show that infection caused ASD or regression. Caregiver-reported infections before age three could be affected by recall bias, and medical records only covered the neonatal hospital period. 35% of enrolled children were excluded because they did not complete the study or caregiver questionnaire, and lower completion was associated with lower maternal education, younger age and non-white race. Neonatal record abstractors were not blinded to case status, although case status may not have been apparent in the records. The caregiver questionnaire did not allow total numbers of infections, and asymptomatic or minor infections not diagnosed by a healthcare professional were not captured. Comparisons with developmental delay controls showed fewer and smaller differences, so the findings do not show that infection specifically distinguishes ASD from other developmental delays. The estimates for regression comparisons were imprecise because few children had regression, so other differences could not be ruled out.
Declared interests
The authors declare no conflict of interest. The article is listed as supported by U.S. government Public Health Service research.
The easy way to misread this
Do not conclude that infections cause autism or that preventing infections would prevent autism. The study compared infection history in children with autism and control groups; it did not test infection as a cause, and many associations were not present when autism was compared with other developmental delays.