孤独症、精神发育迟滞的围生期危险因素及家族史的病例对照研究

Perinatal risk factors and family history of autism and mental retardation:a case control study

【目的】研究孤独症和精神发育迟滞的围生期危险因素及相关家族史之间的差异。【方法】分析在复旦大学附属儿科医院诊治的100例孤独症儿童、60例精神发育迟滞儿童以及80例发育正常儿童的围生期及家族史资料,应用方差分析、秩和检验以及χ2检验分析三组儿童围生期危险因素及家族史之间的差异。【结果】孤独症及精神发育迟滞儿童有家族史的比例显著高于正常儿童(35.0%vs 6.3%,P<0.001;31.7%vs 6.3%,P=0.005),而孤独症组和精神发育迟滞组的家族史差异无统计学意义(P=0.362)。三组儿童有孕期疾病史的比例存在差异(28.00%vs 45.00%vs26.25%,χ2=6.635,P=0.036),但两两比较后发现各组之间差异均不显著。孤独症组母亲的孕龄显著高于正常儿童组(P<0.001),与精神发育迟滞组差异不显著,而精神发育迟滞组与正常儿童组之间的差异也不显著。三组儿童围生期缺氧或窒息史的比例不存在显著差异(8.00%vs 10.00%vs 2.50%,χ2=3.589,P=0.166)。在胎产次、孕周、生产方式、产重上,三组儿童之间差异也无统计学意义。【结论】1)孤独症与精神发育迟滞患儿家族史的阳性率不相上下,但均显著高于正常儿童;2)晚孕可能是孤独症的一个危险因素。

【Objective】 To explore the differences of perinatal risk factors and relative family history between autism and mental retardation. 【Methods】 A case-control study carried out on three groups：100 autistic patients,60 mental retardation patients and 80 healthy controls with normal development.Patients and controls in the three groups were recruited from Children＇s Hospital of Fudan University.ANOVA,Rank-sum test and Chi-square test methods for statistical analyses were used. 【Results】 Both patient groups with autism and mental retardation had a significantly higher rate of family history（35.0% vs 6.3%,P〉0.001;31.7% vs 6.3%,P=0.005）than control group.However,there was no statistical significance between the two patient groups（P=0.362）.The rates of maternal conditions during pregnancy were different between three groups（28.00% vs 45.00% vs 26.25%,χ2=6.635,P=0.036）,but there was no statistically significant difference between every pairs of groups in pairwise comparison.Maternal age in autistic group was significantly higher than that of control group（P〉0.001）.With respect to perinatal history of hypoxia or asphyxia,no significant difference was observed between the three groups,neither were No.of previous pregnancies and deliveries,gestational age at birth,mode of delivery and birth weight. 【Conclusions】 1）Patients with autism and mental retardation have a similar rate of family history,and both are significantly higher than the normal children;2）Late pregnancy may be a risk factor for autistic disorder.