环境因素暴露与自闭症谱系障碍相关性的研究进展

Research progress on relationships between environmental factor exposure and autism spectrum disorder

自闭症谱系障碍是一组以语言发育障碍、人际交往缺陷、行为重复刻板和兴趣狭窄为主要特征的复杂的神经发育障碍,给家庭和社会造成沉重负担,已成为一个全球性的公共卫生问题。迄今,自闭症谱系障碍的病因尚无定论。随着研究的不断深入,环境因素被认为是自闭症谱系障碍重要的致病因素之一。众所周知,妊娠期、围生期及婴幼儿期是胎儿及儿童生长发育的关键时期。此时期暴露于高危环境因素,可影响胎儿及儿童的中枢神经系统发育,从而增加儿童罹患自闭症谱系障碍的风险。因此,本文对妊娠期父母生育年龄、空气氮氧化物污染暴露、母亲药物使用及毒物暴露、妊娠合并症及并发症,围生期早产、胎儿生长受限或低出生体重儿、剖宫产及催产素暴露,以及婴幼儿期的婴幼儿疾病、药物使用及毒物暴露、喂养方式及营养、肠道菌群等多种环境因素暴露与自闭症谱系障碍的相关性进行综述,旨在为自闭症谱系障碍的病因学研究及流行病学调查提供参考,为自闭症谱系障碍的防治提供新的思路和方法。

Autism spectrum disorder is a complex set of neurodevelopmental disorders characterized by deficits in language development and interpersonal communication,as well as restricted and repetitive patterns of behaviors and interests.It has caused a heavy burden on families and society,and has become a global public health problem.So far,the etiology of autism spectrum disorder has not been determined.With the continuous in-depth studies,environmental factors are considered to be one of the important pathogenic factors for autism spectrum disorder.As we all know,pregnancy,peripartum,and infancy are critical periods for the growth and development of fetuses and children.Exposure to high-risk environmental factors during the periods can affect the development of central nervous system of fetuses and children,and thereby may increase the risk of children suffering from autism spectrum disorder.Therefore,this article reviewed the relationships between exposure to environmental factors and autism spectrum disorder.These environmental factors spanned from pregnancy(e.g.parent’s childbearing age,ambient nitric oxide exposure,maternal medication use and toxic exposure,and pregnancy complications and comorbidities),perinatal period(e.g.preterm birth,fetal growth restriction or low birth weight infants,cesarean section,and oxytocin exposure),to infancy(e.g.infant diseases,infant medication use and toxic exposure,feeding patterns and nutrition,and intestinal microflora).This article aimed to provide reference for the etiological research and epidemiological investigation of autism spectrum disorder,as well as provide new ideas and methods for the prevention and treatment of the disease.