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Sex Differences in Autistic Youth Born Extremely Preterm

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Abstract

Purpose

To evaluate sex differences in autistic traits in youth born extremely preterm (EP; 23–27 weeks) who were later diagnosed with autism spectrum disorder (ASD) at 10-years.

Method

A longitudinal cohort design from the Extremely Low Gestational Age Newborn Study (ELGAN) followed N = 857 EP infants from birth through 10-years. EP infants later diagnosed with ASD (N = 61, 20 females) participated in the study. Group differences were evaluated via inferential and Bayesian statistics (values > 1 suggest evidence for alternate hypothesis) on ASD screeners (M-CHAT at 2-years, SCQ and SRS-2 at 10-years), and gold-standard diagnostic measures (ADOS-2, ADI-R) at 10-years.

Results

Males scored significantly higher than females on measures of Social Affect from the ADOS-2, t(34.27)=-2.20, BF10 = 2.33, and measures of Repetitive and Restricted Behaviors from the ADI-R, t(40.52)=-2.85, BF10 = 5.26. Bayesian estimates suggested marginal evidence for sex differences in Nonverbal Communication, t(30.66)=-1.81, BF10 = 1.25, and Verbal Communication, t(24.64)=-1.89, BF10 = 1.39, from the ADI-R, wherein males scored higher than females. No statistically significant sex differences were identified on any of the ASD screeners at 2 (M-CHAT) or 10 years (SCQ). No significant sex differences were observed on any subscales of the SRS at 10 years.

Conclusions

EP autistic males present with more autistic traits than EP autistic females on gold-standard diagnostic measures of autism at 10-years of age, despite not presenting with higher autistic traits on screeners at either age. These results align with sex differences observed in full-term, autistic youth. These results suggest ASD screeners may under identify autism in EP youth, particularly females.

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Data Availability

Data is available upon request from the authorship team.

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Funding

This research was supported by the National Institute of Neurological Disorders and Stroke (5U01NS040069-05 to Alan Leviton; 2R01NS040069-06A2 to Karl Kuban), the Office of the NIH Director (1UG3OD023348-01 to T.M.O.), the National Institute of Child Health and Human Development (5R01HD092374-05 T.M.O. and R.C.F.) and a training fellowship from NICHD (T32 HD040127-21; T.C.M). The authors have no conflicts of interest to disclose. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Author information

Authors and Affiliations

  1. Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

    Tyler C. McFayden

  2. Department of Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

    Clare Harrop

  3. TEACCH Autism Program, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

    Clare Harrop

  4. Gillings School of Global Public Health, Department of Environmental Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

    Kyle Roell

  5. The Institute for Environmental Health Solutions, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

    Kyle Roell

  6. Department of Anatomy and Neurobiology, Chobanian and Avedisian School of Medicine, Boston University, Boston, Massachusetts, USA

    Robert M. Joseph

  7. Department of Environmental Sciences and Engineering, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

    Rebecca C. Fry

  8. Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC, USA

    T. Michael O’Shea

Authors
  1. Tyler C. McFayden
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  2. Clare Harrop
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  3. Kyle Roell
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  4. Robert M. Joseph
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  5. Rebecca C. Fry
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  6. T. Michael O’Shea
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Contributions

TCM: Conceptualization, Investigation, Methodology, Project Administration, Visualization, Writing-Original Draft, Writing- Review and Editing. CH: Conceptualization, Investigation, Methodology, Supervision, Writing- Review & Editing. KR: Data Curation, Formal Analysis, Software, Writing- Review & Editing. RMJ: Data Curation, Methodology, Supervision, Writing- Review & Editing. RF: Funding Acquisition, Supervision, Writing-Review & Editing. MO: Conceptualization, Funding Acquisition, Investigation, Resources, Supervision, Writing- Review & Editing.

Corresponding author

Correspondence to Tyler C. McFayden.

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McFayden, T.C., Harrop, C., Roell, K. et al. Sex Differences in Autistic Youth Born Extremely Preterm. J Autism Dev Disord (2024). https://doi.org/10.1007/s10803-024-06319-0

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