合肥市孤独症儿童生命早期影响因素的病例对照研究

Case-control study on the risk factors of autistic children during early life in Hefei

目的分析儿童孤独症生命早期的影响因素,为孤独症的早期预防提供参考依据。方法2019年6—9月在合肥市某三甲医院收集新诊断的100例孤独症儿童作为病例组,通过性别和年龄匹配,按照1:2配对在合肥市收集198例正常发育儿童作为对照。调查患儿家庭基本情况、母亲孕产期情况、儿童出生后2年内情况。结果Logistic回归分析显示,父母及祖父母近亲结婚(OR=13.154,95%CI:2.225~77.785)、三代内有癫痫、智力低下、运动异常或精神疾病(OR=8.245,95%CI:2.165~31.394)、母亲性格内向(OR=3.263,95%CI:1.345~7.919)、孕期服用广谱抗生素(OR=4.967,95%CI:1.344~18.362)、早产(OR=3.698,95%CI:1.543~8.858)为孤独症发生的危险因素(P<0.05);新生儿期表现(与异常安静相比,容易哭闹OR=0.275,95%CI:0.097~0.782)、2岁内户外活动时间长(与每天<1h/d相比,1~2h/d OR=0.203,95%CI:0.050~0.828,>2h/d OR=0.189,95%CI:0.048~0.747)为孤独症发生的保护因素(P<0.05)。结论孤独症的发生受遗传因素、母亲性格类型、孕期抗生素使用、早产情况、新生儿期表现及2岁内户外活动时间的影响,建议结合这些方面加强孤独症生命早期防治工作。

Objective To explore the risk factors of childhood autism in early life,in order to provide reference for early prevention of autism.Methods A total of 100children newly diagnosed with autism in a tertiary hospital in Hefei from June to September,2019,were enrolled in the case group.And 198typical developed children were selected as the control group,matched by gender and age in 1:2 case control study.Basic information of the family,mother′s situation during pregnancy and delivery period,and the children′s situation within 2years after birth were investigated.Results Logistic regression analysis showed that marriage between blood relatives within three generations(OR=13.154,95%CI:2.225-77.785),epilepsy,mental retardation,dyskinesia or mental illness within three generations(OR=8.245,95%CI:2.165-31.394),maternal introversion personality(OR=3.263,95%CI:1.345-7.919),taking broad-spectrum antibiotics during pregnancy(OR=4.967,95%CI:1.344-18.362),premature(OR=3.698,95%CI:1.543-8.858)were risk factors for autism.Neonatal performance(compared with abnormal quiet,crying OR=0.275,95%CI:0.097-0.782),outdoor activity for at least 1hour/day within 2years old(1-2hours/day OR=0.203,95%CI:0.050-0.828,>2hours/day OR=0.189,95%CI:0.048-0.747)were the protective factors of autism.Conclusions The occurrence of autism is affected by genetic factors,mother′s personality type,antibiotic use during pregnancy,premature delivery,neonatal performance and outdoor activity time within 2years old.It is suggested to strengthen the early prevention and treatment of autism from the perspectives of these aspects.