Mortality risk among Autistic children and young people: A nationwide birth cohort study

Autism has been associated with increased mortality risk among adult populations, but little is known about the mortality risk among children and young people (0-24 years). We used a 15-year nationwide birth cohort study using linked health and non-health administrative data to estimate the mortality risk among Autistic children and young people in Aotearoa/New Zealand. Time-to-event analysis was used to determine the association between autism and mortality, controlling for sex, age, ethnicity, deprivation and rurality of residence. The participant population included 895,707 children of whom 11,919 (1.4%) were identified as Autistic. Autism was associated with a significantly higher mortality risk (hazard ratio = 2.35; 95% confidence interval = 1.80-3.06) compared to the general population. In addition, using stratified analyses, we found that this risk was significantly higher among females (hazard ratio = 5.40; 95% confidence interval = 3.42-8.52) compared to males (hazard ratio = 1.82; 95% confidence interval = 1.32-2.52). We also determined that among Autistic young people, mortality risk was significantly higher for those with a co-occurring intellectual disability (hazard ratio = 2.02; 95% confidence interval = 1.17-3.46). In this study, autism was associated with higher mortality in children and young people compared to the non-Autistic population. Increased efforts are required to better meet the health needs of this population.Lay abstract Existing literature indicates that Autistic people have shorter life expectancy, but little is known about the mortality risk among Autistic children and young people (0-24 years). We used a 15-year nationwide birth cohort study to estimate the mortality risk among Autistic children and young people in Aotearoa/New Zealand. The study included 895,707 children and 11,919 (1.4%) were Autistic. We found that autism was associated with a significantly higher mortality risk compared to the non-Autistic population. In addition, we found that this risk was significantly higher among females compared to males and for those with a co-occurring intellectual disability. Increased efforts are required to better meet the health needs of this population.