Babies born prematurely, especially those born very early (before 32 weeks of gestation), have been found to have a higher likelihood of developing autism spectrum disorders (ASD) compared to babies born at full term. Research indicates that premature birth is a significant risk factor associated with increased rates of ASD diagnosis[1][2][4].
Premature birth refers to babies born before 37 weeks of pregnancy, with very preterm defined as before 32 weeks. These infants often face unique neurodevelopmental challenges due to the early disruption of brain development and exposure to medical complications in the neonatal intensive care unit (NICU). Studies have shown that the prevalence of ASD among preterm children is notably higher than in the general population. For example, one study found that about 5.9% of premature infants were diagnosed with ASD, compared to 1.9% in full-term infants[2].
The biological and medical reasons behind this increased risk are complex and multifactorial. Premature infants often experience medical interventions at birth, abnormal labor durations, and neonatal asphyxia (oxygen deprivation), all of which have been statistically linked to higher odds of ASD. Specifically, neonatal asphyxia was associated with a more than sevenfold increase in ASD risk, while medical interventions like assisted delivery doubled the risk[2]. These factors can contribute to brain injury or altered brain development, which may underlie the emergence of autism symptoms.
Researchers at the University of South Carolina have been conducting longitudinal studies following preterm infants admitted to the NICU to better understand these links. They observed strong associations between physiological measures in the NICU, such as heart rate and temperature regulation, and later autism symptoms by age three[1]. This research highlights the importance of early detection and monitoring in preterm infants to identify those at risk for ASD and provide timely interventions.
Screening for autism in preterm children presents challenges because their neurodevelopmental profiles often overlap with behaviors seen in ASD, making diagnosis more difficult. A systematic review of ASD screening tools in preterm populations found wide variability in sensitivity and specificity, indicating that current tools may not be fully reliable for this group[4]. This underscores the need for refined screening methods tailored to the unique developmental trajectories of preterm infants.
In addition to prematurity, other perinatal factors such as prolonged labor and medical interventions during birth also contribute to autism risk, suggesting that the birth process and early neonatal environment play critical roles in neurodevelopmental outcomes[2].
Overall, the evidence from multiple authoritative studies and ongoing research projects supports that babies born prematurely are at an increased risk of developing autism spectrum disorders. This risk is influenced by a combination of gestational age, medical complications, and early physiological stressors. Early identification and intervention are crucial to support the developmental needs of these children and improve long-term outcomes[1][4].
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Sources:
[1] South Carolina Public Radio, 2025: Early detection helped Hayden. Why 2 USC researchers are studying links between premature birth and autism.
[2] AME Publishing Company, 2024: Prevalence and key perinatal risk factors of autism spectrum disorder.
[4] American Academy of Pediatrics, 2025: Screening for Autism in Preterm Children: A Systematic Review.
