摘要
目的分析儿童孤独症谱系障碍(ASD)行为的孕前及孕期相关危险因素。方法选取2016年2月至2018年3月于唐山市妇幼保健院行孕期保健的2102名产妇及其单胎新生儿,随访并评定36月龄幼儿的ASD行为,按诊断结果将其分为ASD组(21例)与非ASD组(2081例),比较两组的临床资料,采用Logistic回归模型分析儿童ASD行为孕前及孕期危险因素。结果在2102名幼儿中,诊断为ASD者21例;两组产妇文化水平(χ^(2)=8.188,P=0.017)、孕前3个月具有不良因素接触史(χ^(2)=9.198,P=0.002)、孕期吸烟/被动吸烟(χ^(2)=20.974,P<0.001)、孕期具有不良因素接触史(χ^(2)=6.873,P=0.009)、孕期情绪(χ^(2)=24.754,P<0.001)因素分布比较差异均有统计学意义。经Logistic回归分析显示,孕前3个月具有不良因素接触史(OR=12.195,95%CI:6.412~23.194,P<0.001)、孕期吸烟/被动吸烟(OR=5.983,95%CI:3.713~9.596,P<0.001)、孕期具有不良因素接触史(OR=4.170,95%CI:2.862~6.076,P<0.001)、孕期焦虑/抑郁情绪(OR=3.438,95%CI:2.739~4.316,P<0.001)均为儿童ASD的独立危险因素,产妇文化水平高为儿童ASD的保护因素(OR=0.350,95%CI:0.265~0.464,P<0.001)。结论儿童ASD行为的危险因素为孕前3个月/孕期具有不良因素接触史、孕期吸烟/被动吸烟及孕期焦虑/抑郁情绪,临床应早期予以及时预警干预,以降低儿童ASD的发生风险。
Objective To analyze pregestational and antenatal risk factors of autism spectrum disorders(ASD)behaviors in children.Methods A total of 2,102 pregnant women who received antenatal care in Tangshan Municipal Maternity and Child Health Hospital and their singleton neonates over a period from February 2016 to March 2018 were enrolled in this study.The infants were followed-up,and the infant′s ASD behaviors at 36-month-old were evaluated.They were divided into ASD group and non-ASD group according to presence or absence of ASD behaviors.The clinical data of the infants in the two groups were compared.Logistic regression model was used to analyze pregestational and antenatal risk factors of ASD behaviors.Results Of 2,102 infants,21 infants were diagnosed as ASD.There were statistically significant differences in maternal educational level(χ^(2)=8.188,P=0.017),exposure to adverse factors in 3 months before pregnancy(χ^(2)=9.198,P=0.002),smoking/passive smoking during pregnancy(χ^(2)=20.974,P<0.001),exposure to adverse factors during pregnancy(χ^(2)=6.873,P=0.009),and emotional expression of the pregnant women during their pregnancy(χ^(2)=24.754,P<0.001)between the two groups.Logistic regression analysis showed that maternal exposure to adverse factors in 3 months before pregnancy,exposure to adverse factors during pregnancy,smoking/passive smoking during pregnancy,and anxiety/depression during pregnancy were independent risk factors for ASD in children(Waldχ^(2)=58.141,55.104,55.316 and 113.349 respectively,all P<0.001),while high maternal educational level was a protective factor(Waldχ^(2)=53.812,P<0.001).Conclusion Maternal exposure to adverse factors in 3 months before pregnancy/during pregnancy,smoking/passive smoking during pregnancy,and anxiety/depression during pregnancy are all risk factors for ASD in children.Early clinical warning and intervention should be carried out in time to reduce the risk of ASD in children.
作者
董静怡
杜文冉
崔立华
王兰英
张阳
DONG Jingyi;DU Wenran;CUI Lihua;WANG Lanying;ZHANG Yang(Department of Child Health,Tangshan Municipal Maternity and Child Health Hospital,Hebei Tangshan 063000,China;School of Public Health,North China University of Science and Technology,Hebei Tangshan 063200,China)
出处
《中国妇幼健康研究》
2023年第1期5-9,共5页
Chinese Journal of Woman and Child Health Research
基金
河北省卫生厅科研基金项目(20181318)。
关键词
儿童
孤独症谱系障碍
孕前
孕期
危险因素
child
autism spectrum disorders(ASD)
pregestational period
gestational period
risk factor
