不良分娩事件和儿童自闭症 - 有没有联系?
Hagar Brami1, Omri Zamstein1, Tamar Wainstock2
1Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben Gurion University of the Negev, Beer-Sheva, Israel.
概括
不良的围产期结局,如低的阿帕格评分或带血pH值,与儿童患自闭症谱系障碍 (ASD) 的风险增加无关. 这项大型研究发现,困难分娩和以后的自闭症诊断之间没有联系.
科学领域:
- 围产儿医学 围产儿医学
- 神经发育障碍 神经发育障碍
- 儿科流行病学 儿科流行病学
背景情况:
- 自闭症谱系障碍 (ASD) 的患病率在全球范围内正在增加,但其潜在机制和围产期风险因素仍然不清楚.
- 了解围产不良事件和自闭症之间的潜在联系对于早期识别和干预策略至关重要.
研究的目的:
- 调查不良周产期结果与儿童患自闭症谱系障碍 (ASD) 风险之间的关联.
- 分析特定的围产期不良事件是否与更高的ASD诊断发病率相关.
主要方法:
- 基于人口的队列分析包括165,989个出生.
- 围产期不良结果被定义为5分钟Apgar分数<7,带血pH<7.0,或需要干预的非令人放心的胎儿心率.
- 卡普兰-梅尔生存曲线和考克斯比例危险模型用于评估ASD发病率和控制混因素.
主要成果:
- 在165,989个分娩中,6.7%的分娩经历了不良周围结果,通常与子宫内生长限制,早产和剖腹产有关.
- 共有862名后代被诊断出患有自闭症.
- 在围产期不良结果和ASD风险之间没有发现统计学意义上的关联 (调整后HR=0.96,95%CI 0.75-1.22,p=0.72).
结论:
- 负面的分娩事件,虽然对新生儿健康至关重要,但似乎不会增加儿童患自闭症谱系障碍的长期风险.
- 这项研究表明,除了直接的围产期并发症之外的因素可能对ASD的病因更有影响.
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