目的 探讨孕前及孕期母亲被动吸烟暴露与子代孤独症谱系障碍(ASD)发生风险的关联,为ASD的预防提供理论依据。方法 采用病例对照研究,选取2018—2020年广州市妇女儿童医疗中心和康复机构确诊的141名ASD儿童(ASD组)和247名正常健康儿童(对照组)纳入研究,采用调查问卷收集家庭一般情况与烟草被动暴露情况等资料,采用单因素及多因素Logistic回归分析孕前及孕期母亲被动吸烟暴露与子代ASD发生风险之间的关联。结果 多因素Logistic回归分析结果提示:怀孕之前的3个月母亲经常被动吸烟暴露(OR=6.69,95%CI:2.33~19.25)和怀孕期间母亲经常被动吸烟暴露(OR=5.78,95%CI:2.15~15.49)是子代发生ASD的危险因素。校正儿童性别、产次、母亲学历、母亲孕期多维元素服用、孕前父亲被动吸烟后,上述结果趋势未改变。将对照组和ASD组人群性别匹配后进一步进行敏感性分析,母亲孕前及孕期烟草暴露仍为子代ASD发病的危险因素。结论 孕前及孕期母亲被动吸烟暴露可能引起子代ASD发病风险增加。
Abstract
Objective To explore the association between maternal passive smoking exposure before/during pregnancy and the risk of autism spectrum disorders (ASD) in offspring, so as to provide theoretical reference for the prevention of ASD. Methods A total of 141 children diagnosed with ASD (ASD group) in Guangzhou Women and Children's Medical Center and a rehabilitation organization and 247 healthy children (control group) were enrolled in this case-control study. The questionnaire survey was performed to collect the general characteristics and parental passive smoking exposure information. Univariate and multivariate Logistic regression analysis were used to examine the association between perinatal maternal passive smoking exposure and the risk of ASD in their offspring. Results Maternal passive smoking exposure either before pregnancy (crude OR=6.69,95%CI:2.33 - 19.25) or during pregnancy(crude OR=5.78,95%CI:2.15 - 15.49) had significantly increased the risk of ASD in their offspring. After adjusting the confounders such as children's sex, parity, maternal education, maternal vitamin intake and paternal passive smoking before pregnancy, the trends above remained. After sex matching, the sensitivity analysis showed that maternal tobacco exposure before and during pregnancy still served as a risk factor for offspring's ASD. Conclusion Perinatal maternal passive smoking exposure might be associated with the increasing risk of offspring's ASD.
关键词
孤独症谱系障碍 /
被动吸烟 /
孕前 /
孕期 /
母亲
Key words
autism spectrum disorder /
passive smoking /
before pregnancy /
during pregnancy /
mother
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基金
重大慢性非传染性疾病防控研究“重点专项项目(2016YFC1306205);广州市卫健委项目(20191A011028);广东省科技厅项目(2016A020215019);广州市妇女儿童医疗中心内部基金项目(YIP-2018-049)
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