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＜1 h/d相比,1~2 h/d OR＝0.203,95%CI:0.050～0.828,＞2 h/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。
Abstract
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 100 children newly diagnosed with autism in a tertiary hospital in Hefei from June to September,2019,were enrolled in the case group.And 198 typical 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 2 years 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 1 hour/day within 2 years old(1-2 hours/day OR=0.203,95%CI:0.050-0.828,＞2 hours/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 2 years old.It is suggested to strengthen the early prevention and treatment of autism from the perspectives of these aspects.
关键词
孤独症 /
生命早期 /
儿童
Key words
autism /
early life /
children
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基金
安徽省省级“六卓越、一拔尖”卓越人才培养创新项目(2018zygc118);安徽省省级重点教学研究项目(2018jyxm0780);2019年国家级大学生创新创业训练项目(201910366052)
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