Individuals with fetal and neonatal alloimmune thrombocytopenia (FNAIT) are at an elevated risk for autism, according to the results of a survey sent to members of a mothers-with-FNAIT group called Naitbabies.
Findings from the survey will be presented at the 66th American College of Hematology (ASH) Annual Meeting & Exposition on Dec. 7 through Dec. 10, in San Diego, CA.
FNAIT is associated with parental platelet antigen incompatibility and maternal sensitization. This event, in turn, leads to thrombocytopenia, which may be complicated by the occurrence of intracranial hemorrhage (ICH).
Based on the belief among members of NAITbabies that autism rates might be elevated in FNAIT-affected children, the researchers sought to assess neurodevelopmental issues—autism, in particular—in FNAIT-impacted children both with and without a history of ICH.
Survey methods
Mothers who completed the survey evaluated the neurodevelopmental behavior of their children via the use of four age-specific autism screening scales, in an effort to identify those children with FNAIT children deemed to be at high risk for such issues. These included:
- Q-CHAT-10: assesses children aged 18 to 24 months
- M-CHAT: assesses children aged 2 to 4 years
- AQ10-Child: assesses children aged 4 to 11 years
- AQ10-Adolescent: assesses children aged 12 years or older
Read more about the FNAIT care team
The study cohort comprised responses that depicted a total of 324 children across the four different age groups. Among these 324 individuals, 55 had experienced ICH and 269 had not experienced ICH.
Autism rates among children with and without ICH
Results of the survey revealed a higher prevalence of an autism diagnosis in the ICH group compared with the non-ICH group, other than in the 18-to-24-month age group, in which no diagnoses of autism were reported.
In the 18-to-24-month age group, three of five children with ICH screened at risk for autism, and none of the 15 children without ICH were deemed at risk for autism. Among those in the 2-to-4-year-old age group, one child with ICH had received a prior autism diagnosis, screening identified two of 15 children considered to be at risk, and none of the 49 individuals without ICH were diagnosed with or deemed to be at risk for autism.
In the 4-to-11-year-old age group, autism diagnoses were similar among those with ICH and those without ICH (7.4% vs 6.8%, respectively). In contrast, the use of screening revealed that 33% of individuals who had experienced ICH vs 13% of those who had not experienced ICH were at an increased risk for autism.
The highest rates of autism detected via diagnosis and screening were in the 12 and over age group. In this group, four of 11 children who had experienced ICH compared with 7 of 59 of those who had not experienced ICH had the greatest incidence of autism.
“Overall, in the ICH group, there was a substantial increase in positive screening (high risk) results compared [with] pre-reported autism diagnoses across all four age groups, but the screening total for high risk never exceeded 45% of ICH cases.”
More than one-third of those in the oldest age group screened at high risk for autism.
“The results demonstrate that autism, and probably other neurodevelopmental issues, may become more apparent with age in both the ICH and no ICH groups,” the authors highlighted. “These screening results indicate the need for screening, which may need to be repeated at intervals, for autism in particular and neurologic damage in general in children affected by FNAIT independent of whether an ICH occurred,” they concluded.
