自閉症光譜症候群是源自兒童早期的神經發展障礙，特色是溝通社交困難合併固著行為模式。目前已知早產兒相較於足月兒，更容易合併自閉症光譜症候群，然而其確實發生率仍然未知。此外，早產兒自閉症光譜症候群的症狀行為特徵、早期發展軌跡、以及神經生物基礎，目前仍不清楚。
為研究自閉症光譜症候群於早產兒之發生率，本研究納入台南地區出生週數<32週、出生體重<1500克、追蹤至5歲之早產兒。除一般發展評估，每位早產兒於5歲接受自閉症光譜症候群診斷工具Autism Diagnostic Observation Schedule (ADOS) 及Autism Diagnostic Interview-Revised (ADI-R)之施測。台南地區非常早產兒於五歲追蹤率為87%。透過全面診斷施測，我們發現7.7%的自閉症光譜症候群發生率。
為了解早產兒自閉症光譜症候群之症狀嚴重度及行為特徵，收案一組出生懷孕週數>37週、經ADOS與ADI-R診斷之足月兒自閉症光譜症候群。以區別分析18位早產及44位足月自閉症光譜症候群兒童，發現兩組在ADI-R呈現不同嚴重度的社交互惠性。早產兒非語言社會互動行為較差，但同儕關係及社會情緒互惠性優於足月兒。足月兒童社會互動表現異質性大，相對的，早產兒童社會互動模式則較均質。
為瞭解早期神經發展軌跡是否可作為早產兒自閉症光譜症候群指標，以Group-based trajectory modeling分析其於年齡6個月、12個月、及24個月之發展商數。早產兒智能發展有三種軌跡：低分下降、高分下降、及高分穩定，分別對應35%、9%及3%自閉症光譜症候盛行率。低分下降組較高分穩定組，自閉症光譜症候群風險上升15倍。多類別邏輯回歸分析顯示，男性、使用較久氧氣、及母親教育程度低於大學，與低分下降軌跡相關。因此，早期發展軌跡可以辨識高風險早產兒。
本研究進一步結合出生兩個月內的醫療事件時間序列，透過神經網路深度學習，辨識影響早產兒自閉行為的醫療風險因子，或可改變新生兒重症醫療，減少早產兒自閉行為。此外，結合腦部功能性核磁共振研究，可以提供早產自閉症光譜症候群行為特徵的神經生物基礎，未來可用於客觀診斷、精準分類的依據。
本論文精確診斷並分析早產兒自閉症光譜症候的行為特徵，提出早期發展指標及危險因子，是一個具族群代表性的早產兒自閉症光譜症候群世代研究。

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social communication difficulties and a restricted repetitive behavioral pattern presenting during young childhood. Preterm birth children are more vulnerable to ASD compared with term birth children; however, the incidence of ASD diagnosis through direct assessment on every preterm birth child on the population base remains unclear. Moreover, the behavioral characteristics, early developmental trajectories, and the underlying neurobiological substrate of preterm birth ASD are unknown.
To define ASD incidence in a population-based preterm cohort, every very preterm birth child (gestational age <32 weeks; birth weight <1500 grams) who was discharged from neonatal intensive care units in Tainan and prospectively followed to 5 years of age were enrolled. In addition to developmental examinations, they were also evaluated using the Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview-Revised (ADI-R) for the diagnosis of ASD at 5 years of age. The follow up rate of the population cohort at 5 years old was 87%. Through universal diagnostic assessments, we identified 7.7% of ASD incidence in the very preterm population at 5 years of age.
To define the symptom severity and behavioral characteristics of preterm birth ASD, a group of term birth (gestational age >37 weeks) ASD characterized by ADOS and ADI-R was recruited. Comparing the 18 preterm ASD and 44 term birth ASD children, canonic discriminant analysis identified differences in qualitative abnormalities in reciprocal social interaction of ADI-R. Preterm birth ASD children exhibited worse nonverbal behaviors that regulate social interaction, but more favorable peer relationships and socioemotional reciprocity. In contrast to the heterogeneous severity of social reciprocity in the term ASD group, the behavioral characteristics of the preterm ASD group showed a homogeneous reciprocal social interaction pattern.
To define whether the early-life general developmental trajectory could be an early ASD marker in preterm population, the developmental quotients of all preterm infants at 6 months, 12 months, and 24 months of age were analyzed by group-based trajectory modeling. The mental performance trajectory had 3 patterns: low-declining, high-declining, and high-stable, which corresponded to ASD prevalence of 35%, 9%, and 3%. ASD odds was 15 times higher in the low-declining group than in the high-stable group. Through the analysis of multinomial logistic regression, we found that male infants with longer exposure to oxygen therapy whose mothers had lower maternal education levels tended to follow the low-declining trajectory. Therefore, early-life mental trajectory patterns may lead to identification of vulnerable children born preterm for early ASD diagnosis and targeted intervention.
By applying a deep learning neuronal network, this study could further identify medical risk factors in temporal sequences in the first 2 months of life that could affect autistic behaviors at preschool age. The neonatal critical care might be modified to reduce autistic behaviors in children born very preterm. In addition, functional magnetic resonance imaging studies could provide the neurobiological substrate underlying the phenotype characteristics of preterm birth ASD, that could be used for objective diagnosis and precise classification.
It is a representative population cohort focusing on ASD in the very preterm population, that provides definite diagnosis and behavioral characterization of preterm birth ASD children, and proposes early developmental marker and early-life medical risk factors for early identification/intervention and possibly prevention of ASD.

1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013.
2. Christensen DL, Maenner MJ, Bilder D, et al. Prevalence and characteristics of autism spectrum disorder among children aged 4 years - early autism and developmental disabilities monitoring network, seven sites, United States, 2010, 2012, and 2014. MMWR Surveill Summ. 2019;68(2):1‐19.
3. Kuo HT, Muo CH, Chang YT, Lin CK. Change in prevalence status for children with developmental delay in Taiwan: a nationwide population-based retrospective study. Neuropsychiatr Dis Treat. 2015;11:1541‐1547.
4. Simonoff E, Pickles A, Charman T, Chandler S, Loucas T, Baird G. Psychiatric disorders in children with autism spectrum disorders: prevalence, comorbidity, and associated factors in a population-derived sample. J Am Acad Child Adolesc Psychiatry. 2008;47(8):921‐929.
5. Downs JM, Lechler S, Dean H, et al. The association between comorbid autism spectrum disorders and antipsychotic treatment failure in early-onset psychosis: a historical cohort study using electronic health records. J Clin Psychiatry. 2017;78(9):e1233‐e1241.
6. Yip BHK, Bai D, Mahjani B, Klei L, Pawitan Y, Hultman CM, et al. Heritable variation, with little or no maternal effect, accounts for recurrence risk to autism spectrum disorder in Sweden. Biol Psychiatry. 2018;83:589-597.
7. Tick B, Bolton P, Happé F, Rutter M, Rijsdijk F. Heritability of autism spectrum disorders: a meta-analysis of twin studies. J Child Psychol Psychiatry. 2016;57:585-595.
8. Walker CK, Krakowiak P, Baker A, Hansen RL, Ozonoff S, Hertz-Picciotto I. Preeclampsia, placental insufficiency, and autism spectrum disorder or developmental delay. JAMA Pediatr. 2015;169:154-162.
9. Mezzacappa A, Lasica PA, Gianfagna F, Cazas O, Hardy P, Falissard B, et al. Risk for autism spectrum disorders according to period of prenatal antidepressant exposure: a systematic review and meta-analysis. JAMA Pediatr. 2017;171:555-563.
10. Cheong JLY, Anderson PJ, Burnett AC, Roberts G, Davis N, Hickey L, et al. Changing neurodevelopment at 8 years in children born extremely preterm since the 1990s. Pediatrics. 2017;139:e20164086.
11. Pierrat V, Marchand-Martin L, Arnaud C, Kaminski M, Resche-Rigon M, Lebeaux C, et al. Neurodevelopmental outcome at 2 years for preterm children born at 22 to 34 weeks' gestation in France in 2011: EPIPAGE-2 cohort study. BMJ. 2017;358:j3448.
12. Johnson S, Marlow N. Growing up after extremely preterm birth: lifespan mental health outcomes. Semin Fetal Neonatal Med. 2014;19:97-104.
13. Kuzniewicz MW, Wi S, Qian Y, Walsh EM, Armstrong MA, Croen LA. Prevalence and neonatal factors associated with autism spectrum disorders in preterm infants. J Pediatr. 2014;164:20-25.
14. Agrawal S, Rao SC, Bulsara MK, Patole SK. Prevalence of autism spectrum disorder in preterm infants: a meta-analysis. Pediatrics. 2018;142:e20180134.
15. Joseph RM, O'Shea TM, Allred EN, Heeren T, Hirtz D, Paneth N, et al. Prevalence and associated features of autism spectrum disorder in extremely low gestational age newborns at age 10 years. Autism Res. 2017;10:224-232.
16. Xie S, Heuvelman H, Magnusson C, Rai D, Lyall K, Newschaffer CJ, et al. Prevalence of autism spectrum disorders with and without intellectual disability by gestational age at birth in the Stockholm youth cohort: a register linkage study. Paediatr Perinat Epidemiol. 2017;31:586-594.
17. Johnson S, Hollis C, Kochhar P, Hennessy E, Wolke D, Marlow N. Autism spectrum disorders in extremely preterm children. J Pediatr. 2010;156:525-531.
18. Pinto-Martin JA, Levy SE, Feldman JF, Lorenz JM, Paneth N, Whitaker AH. Prevalence of autism spectrum disorder in adolescents born weighing <2000 grams. Pediatrics. 2011;128(5):883‐891.
19. Pritchard MA, de Dassel T, Beller E, et al. Autism in toddlers born very preterm. Pediatrics. 2016;137(2):e20151949.
20. Randall M, Egberts KJ, Samtani A, et al. Diagnostic tests for autism spectrum disorder (ASD) in preschool children. Cochrane Database Syst Rev. 2018;7(7):CD009044.
21. Lord C, Rutter M, Le Couteur A. Autism Diagnostic Interview-Revised: a revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. J Autism Dev Disord. 1994;24:659-685.
22. Lord C, Rutter M, Goode S, Heemsbergen J, Jordan H, Mawhood L, et al. Autism diagnostic observation schedule: a standardized observation of communicative and social behavior. J Autism Dev Disord. 1989;19:185-212.
23. Falkmer T, Anderson K, Falkmer M, Horlin C. Diagnostic procedures in autism spectrum disorders: a systematic literature review. Eur Child Adolesc Psychiatry. 2013;22:329-340.
24. Limperopoulos C, Bassan H, Sullivan NR, Soul JS, Robertson RL Jr, Moore M, et al. Positive screening for autism in ex-preterm infants: prevalence and risk factors. Pediatrics. 2008;121:758-765.
25. Kuban KC, O'Shea TM, Allred EN, Tager-Flusberg H, Goldstein DJ, Leviton A. Positive screening on the Modified Checklist for Autism in Toddlers (M-CHAT) in extremely low gestational age newborns. J Pediatr. 2009;154(4):535‐540.e1.
26. Moore T, Johnson S, Hennessy E, Marlow N. Screening for autism in extremely preterm infants: problems in interpretation. Dev Med Child Neurol. 2012;54:514-520.
27. Bokobza C, Van Steenwinckel J, Mani S, Mezger V, Fleiss B, Gressens P. Neuroinflammation in preterm babies and autism spectrum disorders. Pediatr Res. 2019;85:155-165.
28. van Tilborg E, Achterberg EJM, van Kammen CM, van der Toorn A, Groenendaal F, Dijkhuizen RM, et al. Combined fetal inflammation and postnatal hypoxia causes myelin deficits and autism-like behavior in a rat model of diffuse white matter injury. Glia. 2018;66:78-93.
29. Lagercrantz H. Are extremely preterm born children with autism the victims of too much isolation in the incubator? Acta Paediatr. 2017;106:1246-1247
30. Ousley O, Cermak T. Autism spectrum disorder: defining dimensions and subgroups. Curr Dev Disord Rep. 2014;1(1):20‐28.
31. Wiggins LD, Tian LH, Levy SE, et al. Homogeneous subgroups of young children with autism improve phenotypic characterization in the study to explore early development. J Autism Dev Disord. 2017;47(11):3634‐3645.
32. Kim SH, Macari S, Koller J, Chawarska K. Examining the phenotypic heterogeneity of early autism spectrum disorder: subtypes and short-term outcomes. J Child Psychol Psychiatry. 2016;57(1):93‐102.
33. Hu VW, Steinberg ME. Novel clustering of items from the Autism Diagnostic Interview-Revised to define phenotypes within autism spectrum disorders. Autism Res. 2009;2(2):67‐77.
34. Hu VW, Sarachana T, Kim KS, et al. Gene expression profiling differentiates autism case-controls and phenotypic variants of autism spectrum disorders: evidence for circadian rhythm dysfunction in severe autism. Autism Res. 2009;2(2):78‐97.
35. Bowers K, Wink LK, Pottenger A, McDougle CJ, Erickson C. Phenotypic differences in individuals with autism spectrum disorder born preterm and at term gestation. Autism. 2015;19:758-763.
36. Gotham K, Pickles A, Lord C. Standardizing ADOS scores for a measure of severity in autism spectrum disorders. J Autism Dev Disord. 2009;39:693-705.
37. Hus V, Gotham K, Lord C. Standardizing ADOS domain scores: separating severity of social affect and restricted and repetitive behaviors. J Autism Dev Disord. 2014;44:2400-2412.
38. Cholemkery H, Medda J, Lempp T, Freitag CM. Classifying autism spectrum disorders by ADI-R: subtypes or severity gradient? J Autism Dev Disord. 2016;46:2327-2339.
39. Bruining H, Eijkemans MJ, Kas MJ, Curran SR, Vorstman JA, Bolton PF. Behavioral signatures related to genetic disorders in autism. Mol Autism. 2014;5:11.
40. Puhr R, Heinze G, Nold M, Lusa L, Geroldinger A. Firth's logistic regression with rare events: accurate effect estimates and predictions? Stat Med. 2017;36:2302-2317.
41. Eryigit-Madzwamuse S, Strauss V, Baumann N, Bartmann P, Wolke D. Personality of adults who were born very preterm. Arch Dis Child Fetal Neonatal Ed. 2015;100:F524-529.
42. Kim SH, Lord C. Combining information from multiple sources for the diagnosis of autism spectrum disorders for toddlers and young preschoolers from 12 to 47 months of age. J Child Psychol Psychiatry. 2012;53:143-151.
43. Clements CC, Zoltowski AR, Yankowitz LD, Yerys BE, Schultz RT, Herrington JD. Evaluation of the social motivation hypothesis of autism: a systematic review and meta-analysis. JAMA Psychiatry. 2018;75:797-808.
44. Dalton KM, Nacewicz BM, Johnstone T, Schaefer HS, Gernsbacher MA, Goldsmith HH, et al. Gaze fixation and the neural circuitry of face processing in autism. Nat Neurosci. 2005;8:519-526.
45. Dougherty CC, Evans DW, Katuwal GJ, Michael AM. Asymmetry of fusiform structure in autism spectrum disorder: trajectory and association with symptom severity. Mol Autism. 2016;7:28.
46. Szatmari P, Georgiades S, Duku E, Bennett TA, Bryson S, Fombonne E, et al. Developmental trajectories of symptom severity and adaptive functioning in an inception cohort of preschool children with autism spectrum disorder. JAMA Psychiatry. 2015;72:276-283.
47. Gray PH, Edwards DM, Gibbons K. Parenting stress trajectories in mothers of very preterm infants to 2 years. Arch Dis Child Fetal Neonatal Ed. 2018;103:F43-48.
48. Havdahl KA, Bishop SL, Surén P, Øyen AS, Lord C, Pickles A, et al. The influence of parental concern on the utility of autism diagnostic instruments. Autism Res. 2017;10:1672-1686.
49. Eriksson JM, Lundström S, Lichtenstein P, Bejerot S, Eriksson E. Effect of co-twin gender on neurodevelopmental symptoms: a twin register study. Mol Autism. 2016;7:8.
50. Geelhand P, Bernard P, Klein O, van Tiel B, Kissine M. The role of gender in the perception of autism symptom severity and future behavioral development. Mol Autism. 2019;10:16.
51. Cauvet É, Van't Westeinde A, Toro R, Kuja-Halkola R, Neufeld J, Mevel K, et al. Sex Differences Along the Autism Continuum: A Twin Study of Brain Structure. Cereb Cortex. 2019;29:1342-1350.
52. Kim SH, Joseph RM, Frazier JA, et al. Predictive validity of the Modified Checklist for Autism in Toddlers (M-CHAT) born very preterm. J Pediatr. 2016;178:101‐107.e2.
53. Rogers SJ. Empirically supported comprehensive treatments for young children with autism. J Clin Child Psychol. 1998;27:168-179.
54. Baird G, Charman T, Baron-Cohen S, Cox A, Swettenham J, Wheelwright S, et al. A screening instrument for autism at 18 months of age: a 6-year follow-up study. J Am Acad Child Adolesc Psychiatry. 2000;39:694-702.
55. Landa R, Garrett-Mayer E. Development in infants with autism spectrum disorders: a prospective study. J Child Psychol Psychiatry. 2006;47:629-638.
56. Nishimura T, Takei N, Tsuchiya KJ. Neurodevelopmental trajectory during infancy and diagnosis of autism spectrum disorder as an outcome at 32 months of age. Epidemiology. 2019;30 Suppl 1:S9-S14
57. Nishimura T, Takei N, Tsuchiya KJ, Asano R, Mori N. Identification of neurodevelopmental trajectories in infancy and of risk factors affecting deviant development: a longitudinal birth cohort study. Int J Epidemiol. 2016;45(2):543-553.
58. Moore T, Johnson S, Haider S, Hennessy E, Marlow N. Relationship between test scores using the second and third editions of the Bayley Scales in extremely preterm children. J Pediatr. 2012;160(4):553-558.
59. Nagin DS, Odgers CL. Group-based trajectory modeling in clinical research. Annu Rev Clin Psychol. 2010;6:109-138.
60. Nagin DS. Group-based trajectory modeling: an overview. Ann Nutr Metab. 2014;65(2-3):205-210.
61. Klijn SL, Weijenberg MP, Lemmens P, van den Brandt PA, Lima Passos V. Introducing the fit-criteria assessment plot - A visualisation tool to assist class enumeration in group-based trajectory modelling. Stat Methods Med Res. 2017;26(5):2424-2436.
62. Puhr R, Heinze G, Nold M, Lusa L, Geroldinger A. Firth's logistic regression with rare events: accurate effect estimates and predictions? Stat Med. 2017;36(14):2302-2317.
63. Tutz G, Pößnecker W, Uhlmann L. Variable selection in general multinomial logit models. Computational Statistics & Data Analysis 2015;82:207-222.
64. Cherrie JA. Variable screening for multinomial logistic regression on very large data sets as applied to direct response modeling [paper 081-2007]. SAS Global Forum, Orlando, FL, 2007.
65. Wang J, Wei R, Jia W. A quick tour of multiROC. Available at: https://mran.microsoft.com/snapshot/2018-02-12/web/packages/multiROC/vignettes/my-vignette.html. Accessed April 1, 2020.
66. Hayes AF, Rockwood NJ. Regression-based statistical mediation and moderation analysis in clinical research: Observations, recommendations, and implementation. Behav Res Ther. 2017;98:39-57.
67. Ployhart RE, Vandenberg RJ. Longitudinal research: the theory, design, and analysis of change. Journal of Management. 2010;36(1):94-120.
68. Bode MM, DʼEugenio DB, Mettelman BB, Gross SJ. Predictive validity of the Bayley, Third Edition at 2 years for intelligence quotient at 4 years in preterm infants. J Dev Behav Pediatr. 2014;35(9):570-575.
69. Yu YT, Hsieh WS, Hsu CH, et al. A psychometric study of the Bayley Scales of Infant and Toddler Development - 3rd Edition for term and preterm Taiwanese infants. Res Dev Disabil. 2013;34(11):3875-3883.
70. Zwaigenbaum L, Bauman ML, Stone WL, et al. Early identification of autism spectrum disorder: recommendations for practice and research. Pediatrics. 2015;136 Suppl 1:S10-40.
71. Landa RJ, Gross AL, Stuart EA, Bauman M. Latent class analysis of early developmental trajectory in baby siblings of children with autism. J Child Psychol Psychiatry. 2012;53(9):986-996.
72. Bryson SE, Zwaigenbaum L, Brian J, et al. A prospective case series of high-risk infants who developed autism. J Autism Dev Disord. 2007;37(1):12-24.
73. Lai MC, Anagnostou E, Wiznitzer M, Allison C, Baron-Cohen S. Evidence-based support for autistic people across the lifespan: maximising potential, minimising barriers, and optimising the person-environment fit. Lancet Neurol. 2020 Mar 3. pii: S1474-4422(20)30034-X. [Epub ahead of print]
74. Nevill RE, Lecavalier L, Stratis EA. Meta-analysis of parent-mediated interventions for young children with autism spectrum disorder. Autism. 2018; 22(2):84-98.
75. Gengoux GW, Abrams DA, Schuck R, et al. A pivotal response treatment package for children with autism spectrum disorder: an RCT. Pediatrics. 2019;144(3). pii: e20190178.
76. Garfinkle J, Yoon EW, Alvaro R, et al; Canadian Neonatal Network Investigators. Trends in sex-specific differences in outcomes in extreme preterms: progress or natural barriers? Arch Dis Child Fetal Neonatal Ed. 2019; pii: fetalneonatal-2018-316399.
77. Kuban KC, Joseph RM, O'Shea TM, et al; Extremely Low Gestational Age Newborn (ELGAN) Study Investigators. Girls and boys born before 28 weeks gestation: risks of cognitive, behavioral, and neurologic outcomes at age 10 years. J Pediatr. 2016;173:69-75.e1.
78. Ferri SL, Abel T, Brodkin ES. Sex differences in autism spectrum disorder: a review. Curr Psychiatry Rep. 2018;20(2):9.
79. Adams-Chapman I, Heyne RJ, DeMauro SB, el; Follow-Up study of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Neurodevelopmental impairment among extremely preterm infants in the neonatal research network. Pediatrics. 2018;141(5). pii: e20173091.
80. Twilhaar ES, Wade RM, de Kieviet JF, van Goudoever JB, van Elburg RM, Oosterlaan J. Cognitive outcomes of children born extremely or very preterm since the 1990s and associated risk factors: a meta-analysis and meta-regression. JAMA Pediatr. 2018;172(4):361-367.
81. Hack M, Taylor HG, Schluchter M, Andreias L, Drotar D, Klein N. Behavioral outcomes of extremely low birth weight children at age 8 years. J Dev Behav Pediatr. 2009;30(2):122‐130.
82. Stålnacke SR, Tessma M, Böhm B, Herlenius E. Cognitive development trajectories in preterm children with very low birth weight longitudinally followed until 11 years of age. Front Physiol. 2019;10:307.
83. BOOST-II Australia and United Kingdom Collaborative Groups, Tarnow-Mordi W, Stenson B, Kirby A, et al. Outcomes of two trials of oxygen-saturation targets in preterm infants. N Engl J Med. 2016;374(8):749-760.
84. Saugstad OD, Oei JL, Lakshminrusimha S, Vento M. Oxygen therapy of the newborn from molecular understanding to clinical practice. Pediatr Res. 2019 Jan;85(1):20-29.
85. Linsell L, Johnson S, Wolke D, et al. Cognitive trajectories from infancy to early adulthood following birth before 26 weeks of gestation: a prospective, population-based cohort study. Arch Dis Child. 2018;103(4):363-370.
86. McManus BM, Poehlmann J. Maternal depression and perceived social support as predictors of cognitive function trajectories during the first 3 years of life for preterm infants in Wisconsin. Child Care Health Dev. 2012;38(3):425-434.
87. Yaari M, Mankuta D, Harel-Gadassi A, et al. Early developmental trajectories of preterm infants. Res Dev Disabil. 2018;81:12-23.
88. Luu TM, Vohr BR, Allan W, Schneider KC, Ment LR. Evidence for catch-up in cognition and receptive vocabulary among adolescents born very preterm. Pediatrics. 2011;128(2):313-322.
89. Harding JF. Increases in maternal education and low-income children's cognitive and behavioral outcomes. Dev Psychol. 2015;51(5):583-599.
90. Joseph RM, Korzeniewski SJ, Allred EN, O'Shea TM, Heeren T, Frazier JA, et al. Extremely low gestational age and very low birthweight for gestational age are risk factors for autism spectrum disorder in a large cohort study of 10-year-old children born at 23-27 weeks' gestation. Am J Obstet Gynecol. 2017;216:304.e1-304.e16.
91. Babata K, Bright HR, Allred EN, et al. Socioemotional dysfunctions at age 10 years in extremely preterm newborns with late-onset bacteremia. Early Hum Dev. 2018;121:1‐7.
92. Cryan JF, Dinan TG. Mind-altering microorganisms: the impact of the gut microbiota on brain and behaviour. Nat Rev Neurosci. 2012;13(10):701‐712.
93. Łukasik J, Patro-Gołąb B, Horvath A, Baron R, Szajewska H; SAWANTI Working Group. Early life exposure to antibiotics and autism spectrum disorders: a systematic review. J Autism Dev Disord. 2019;49(9):3866‐3876.
94. Gibson MK, Wang B, Ahmadi S, et al. Developmental dynamics of the preterm infant gut microbiota and antibiotic resistome. Nat Microbiol. 2016;1:16024.
95. Gers FA, Schmidhuber J, Cummins F. Learning to forget: continual prediction with LSTM. Neural Comput. 2000;12(10):2451‐2471.
96. Zhang X, Chou J, Liang J, et al. Data-Driven Subtyping of Parkinson's Disease Using Longitudinal Clinical Records: A Cohort Study. Sci Rep. 2019;9(1):797.
97. Ecker C, Bookheimer SY, Murphy DG. Neuroimaging in autism spectrum disorder: brain structure and function across the lifespan. Lancet Neurol. 2015;14:1121-1134.
98. Fernández M, Mollinedo-Gajate I, Peñagarikano O. Neural circuits for social cognition: implications for autism. Neuroscience. 2018;370:148-162.
99. Subbaraju V, Suresh MB, Sundaram S, Narasimhan S. Identifying differences in brain activities and an accurate detection of autism spectrum disorder using resting state functional-magnetic resonance imaging : A spatial filtering approach. Med Image Anal. 2017;35:375-389.
100. Drysdale AT, Grosenick L, Downar J, Dunlop K, Mansouri F, Meng Y, et al. Resting-state connectivity biomarkers define neurophysiological subtypes of depression. Nat Med. 2017;23:28-38.
101. Deipolyi AR, Mukherjee P, Gill K, Henry RG, Partridge SC, Veeraraghavan S, et al. Comparing microstructural and macrostructural development of the cerebral cortex in premature newborns: diffusion tensor imaging versus cortical gyration. Neuroimage. 2005;27:579-586.
102. Tokariev A, Stjerna S, Lano A, Metsäranta M, Palva JM, Vanhatalo S. Preterm Birth Changes Networks of Newborn Cortical Activity. Cereb Cortex. 2019 Feb 1;29(2):814-826.
103. Smyser CD, Wheelock MD, Limbrick DD Jr, Neil JJ. Neonatal brain injury and aberrant connectivity. Neuroimage. 2019;185:609-623.