目的 了解珠海市1.5～3岁孤独症谱系障碍(Autism Spectrum Disorders, ASD)的患病率及相关危险因素。方法 随机抽取在珠海市生活的1.5～3岁儿童共5 500人, 使用自编问卷和改良婴幼儿孤独症筛查量表中文修订版进行初筛;对结果阳性者由专科医师根据临床观察及儿童孤独症评定量表评定结果进行确诊;最后统计分析ASD患儿的患病率及危险因素。结果 本次调查ASD患病率为29.45/104(95%CI为15.41/104～44.86/104), 均为典型孤独症患儿, 男女比例为6∶1。ASD组与非ASD组在性别、家庭收入、父母文化程度、母孕期间是否服用特殊药物(避孕药物、抗精神病药物、抗癫痫病药物等)、母孕期间是否补充叶酸、父亲年龄的分布上存在明显不同, 差异有统计学意义(P<0.05);回归分析结果显示家庭收入偏低、母孕期间服用特殊药物、母孕期间未补充叶酸及出生时父亲年龄偏高(>35岁)或偏低(<25岁)等可能为ASD的危险因素。结论 珠海市1.5～3岁ASD患病率低于国内外的报道水平;母亲怀孕时避免使用特殊药物、积极补充叶酸, 避免父亲年龄过高或过低可能有助于降低ASD患病率。
Abstract
Objective To understand the prevalence and the related risk factors of children from 1.5 to 3 years old with autism spectrum disorders (ASD) in Zhuhai city. Methods A total of 5 500 children from 1.5 to 3 years old and living in Zhuhai were selected randomly.The questionnaire and the Chinese Revised Version of the Modified Checklist for Autism in Toddlers were used to screen the ASD.Then, the positive children were diagnosed by physicians combining with the clinical observation and the results of Childhood Autism Rating Scale.Finally, statistical analyses of the prevalence and the related risk factors of ASD were done. Results This survey showed that the prevalence of ASD was 29.45/104 (95%CI15.41/104~44.86/104), they were typical autistic children, and the ratio of male to female was 6∶1.The differences between ASD group and non ASD group in gender, family income, parental education level, mother during pregnancy whether taking special medicines (contraceptive drugs, antipsychotic drugs, anti epilepsy drugs etc), whether supplementary folic acid while pregnant and the father's age distribution were significantly.What's more, the differences were statistically significant (P<0.05).The regression analysis showed that lower family income, taking special drugs while pregnant, not supplementary folic acid while pregnant and paternal age at birth higher (>35 years old) or lower (<25 years old) were the risk factors of ASD. Conclusions The prevalence rate of ASD from 1.5 to 3 years in Zhuhai city is lower than the reported levels of both at home and abroad .The mothers avoiding using special drugs and taking folic acid actively while pregnancy, avoiding father's age too high or too low may help reduce the prevalence rate of ASD.
关键词
孤独症谱系障碍 /
患病率 /
珠海市 /
儿童
Key words
autism spectrum disorders /
prevalence /
Zhuhai city /
children
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基金
珠海市科技计划项目(201311140051)
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