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Poster Session 2

(534) Screening Analysis for Autism Spectrum Disorders in FNAIT-Affected Children with and without Intra-Cranial Hemorrhage

Thursday, January 30, 2025
4:00 PM – 6:00 PM  
Objective: Fetal/neonatal alloimmune thrombocytopenia (FNAIT) results from parental platelet antigen incompatibility. De Vos et al identified increased neurodevelopmental issues in FNAIT-affected children without ICH. Members of NAITbabies suggested increased autism in FNAIT-affected children. Our survey evaluated neurodevelopmental issues (autism) in FNAIT-affected children, with and without ICH.

Study Design: A de-identified survey was distributed via Qualtrics to mothers in NAITbabies and assessed neurodevelopment using 4 age-specific autism screening scales to identify FNAIT-affected children at high risk: Q-CHAT-10 for 18-24 months; M-CHAT 2–4 yrs; AQ10-Child 4 -11; and AQ10-Adolescent for >12 with 20, 61, 173, and 70 children. Mothers reported if autism diagnosis was known prior to screening and responses were scored using algorithms.

Results: There were 324 children across the 4 age groups, 55 with ICH and 269 without. Autism diagnoses were more prevalent in the ICH groups across all ages, except the 18–24-mo group (no reported autism) see Table 1. Most notably, for 2-4yr olds, none of 49 children without ICH reported a diagnosis or screened at risk. Among 4-11yr-olds, screening showed 33% with ICH and 13% without ICH.  The highest levels were in the 12+ age group, reporting 36.4% with ICH and 11.8% without ICH, with screening identifying autism risk in 45% with ICH and 37% without ICH. Overall, while the ICH group showed more high-risk screening compared to pre-reported diagnoses across the 3 older ages, screening totals never exceeded 45% of ICH cases. In the non-ICH groups, at-risk screening was seen in > 1/3 of the 12+ age group.

Conclusion: Autism and other neurodevelopmental issues become more apparent with age in ICH and non-ICH groups. The screening tool is NOT a specific diagnostic test for autism and identifies non-specific neurologic damage. Children affected by FNAIT, especially adolescents, are at risk for “autism” even without ICH. These results indicate the need for periodic screening for autism and neurologic damage in general in children affected by FNAIT, regardless of ICH occurrence.