孤独症谱系障碍危险因素调查分析

Analysis of risk factors for autism spectrum disorder

目的分析孤独症谱系障碍(Autism Spectrum Disorder,ASD)的危险因素,为ASD的预防和干预提供参考依据。方法选取2021年1月~2023年1月在石家庄市某精神病医院确诊为ASD的120例儿童作为病例组,按照1∶1配对方式匹配同期性别、年龄等基本情况相近的健康体检儿童120例作为对照组。收集两组儿童和父母的一般信息、母亲孕产期情况、新生儿情况等信息,应用单因素分析、二元logistic回归分析ASD的危险因素。结果病例组男性为97人(80.8%),平均年龄为(4.78±1.558)岁;对照组男性为98人(81.7%),平均年龄为(4.73±1.527)岁。单因素分析提示:父亲职业、母亲职业、父亲育儿时间、母亲亲子关系、家族史、怀孕年龄、多胎史、早产史、生产方式、孕期疾病史、规律口服叶酸、孕期药物史、孕期情绪波动、生产使用麻醉、胎儿缺氧和高胆红素血症与ASD相关,经多因素logistic回归分析显示:家族史、怀孕年龄39岁以上、母亲无业、母亲的亲子关系、母亲孕期情绪波动、母亲孕期服药为ASD发生的独立危险因素(P<0.05)。父亲育儿时间>2 h/d为ASD发生的独立保护因素(P<0.05)。结论ASD的发生受遗传、母亲孕产期状况及家庭环境等多因素的影响。支持ASD父母心理健康的计划可以在很大程度减少他们的育儿压力,提升育儿干预积极性改善ASD儿童的社交和沟通技能。未来应加强对危险因素的健康宣教,进一步提高全社会的ASD识别意识,强调早期筛查的重要性,以降低ASD的发病风险。

Objective To analyze risk factors associated with autism spectrum disorder(ASD),and to provide related references for the prevention and intervention concerned.Methods 120 children diagnosed with ASD in a psychiatric hospital in Shijiazhuang City from January 2021 to January 2023 were selected as the case group,and 120 healthy children with gender and age matched were chosen as the control group based on 1:1 matching method.The general information of the two groups of children and parents,including maternal conditions,neonatal information,and etc.,were collected.Univariate analysis and binary logistic regression were used to analyze the risk factors of ASD.Results There were 97 males(80.8%)in the case group,and the mean age was(4.78±1.558)years.The control group consisted of 98 males(81.7%)with an average age of(4.73±1.527)years.Univariate analysis suggested that paternal occupation,maternal occupation,paternal parenting time,relationship between mother and children,family history,age of pregnancy,history of multiple births,history of preterm birth,mode of delivery,history of disease during pregnancy,regular oral administration of folic acid,history of drugs during pregnancy,mother’s mood swings during pregnancy,use of anesthesia during delivery,fetal hypoxia and hyperbilirubinemia were associated with ASD.Multivariate logistic regression analysis showed that family history,pregnancy age over 39 years old,mother's unemployment,relationship between mother and children,mother’s mood swings during pregnancy,and mothers'medicine used during pregnancy were independent risk factors for ASD(P<0.05).Paternal parenting time(>2h/d)was an independent protective factor for ASD(P<0.05).Conclusion The occurrence of ASD is influenced by many factors such as heredity,maternal conditions and family environments.Programs to support the mental health of parents with ASD can greatly reduce their parenting stress,enhance the initiative of parenting intervention and improve the social and communication skills of children with ASD.In the future,health education on risk factors should be strengthened,and the awareness of ASD in the whole society should be further improved,in order to emphasize the importance of early detection,thus reducing the risk of ASD.