自闭症和智力障碍风险的区域差异与剖腹产分娩相关
Deborah A Bilder1, Scott Sullivan2, Michelle M Hughes3
1Department of Psychiatry, University of Utah Huntsman Mental Health Institute, Salt Lake City, Utah, USA.
概括
剖腹产 (剖腹产) 显示自闭症谱系障碍 (ASD) 和智力障碍 (ID) 的几率增加. 区域差异表明,剖腹产可能表明其他影响发育风险的暴露.
科学领域:
- 流行病学 流行病学
- 发育儿科 发育儿科
- 公共卫生 公共卫生
背景情况:
- 关于分娩方式和神经发育障碍,如自闭症谱系障碍 (ASD) 和智力障碍 (ID) 的流行病学研究产生了不一致的结果.
- 剖腹产 (剖腹产) 率及其与ASD/ID风险的关联需要进一步调查,特别是考虑到区域差异.
研究的目的:
- 检查与美国不同地区的初级和重复剖腹产相关的ASD和/或ID风险.
- 探索剖腹产率的区域差异及其与神经发育障碍可能性的相关性.
主要方法:
- 利用了CDC自闭症和发育障碍监测网络的数据,用于偶数年 (2000-2016) 患有ASD和/或ID的8岁儿童.
- 匹配了来自国家卫生统计中心的病例组 (仅ASD,ASD+ID,仅ID) 和大型比较出生队列 (N=1,456,914).
- 用美国地区分层调整的模型来分析神经发育障碍的剖腹产风险.
主要成果:
- 整体模型表明,与初级和重复剖腹产相关的残疾 (ASD和/或ID) 几率增加.
- 在与重复剖腹产相关的残疾可能性方面观察到显著的区域变异.
- 在东南和中大西洋地区发现重复剖腹产相关残疾的几率增加,但在西部没有,与区域剖腹产率差异相关.
结论:
- 这些发现表明,剖腹产本身可能不会直接导致增加残疾风险.
- 与重复剖腹产相关的残疾风险的区域差异意味着该程序可能作为其他影响胎儿发育的区域可变暴露的替代品.
- 需要进一步的研究来确定这些暴露,并了解它们对剖腹产率和神经发育结果的影响.
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