- 作者：P盲ivi Polo-Kantola ; Katja M. Lampi ; Susanna Hinkka-Yli-Salom盲ki ; Mika Gissler ; Alan S. Brown ; Andre Sour ; er
- 关键词：ASD ; Autism spectrum disorder ; FHDR ; Finnish Hospital Discharge Register ; FIPS-A ; Finnish Prenatal Study of Autism ; FMBR ; Finnish Medical Birth Register ; ICD-9 ; International Classification of Diseases-9th Revision ; ICD-10 ; International Classification of Diseases-10th Revision ; NICU ; Neonatal intensive care unit ; PAR ; Population attributable risk ; PDD ; Pervasive developmental disorder ; SES ; Socioeconomic status ; SGA ; Small for gestational age
- 刊名：The Journal of Pediatrics
- 出版年：February, 2014
- 年：2014
- 卷：164
- 期：2
- 页码：358-365
- 全文大小：174 K
Objective
To examine the relationship between obstetric risk factors and childhood autism, Asperger syndrome, and other pervasive developmental disorders (PDDs).Study design
Registry-based case-control study from all singleton births in Finland from 1990-2005. Cases with childhood autism, Asperger syndrome, or PDD (n = 4713) were identified from the Finnish Hospital Discharge Register. Each case was matched to 4 controls on sex, date of birth, and place of birth. Information on obstetric risk factors was from the Finnish Medical Birth Register. Conditional logistic regression models were used for statistical analyses.
Results
When adjusted with confounders, childhood autism was associated with maternal high blood pressure (OR 1.49, 95% CI 1.1-2.1, P = .018), Apgar scores less than 7 (1 minute, OR 1.46, 95% CI 1.1-2.0, P = .021), and neonatal treatment with monitoring (OR 1.40, 95% CI 1.02-1.9, P = .038). PDD was associated with induced labor (OR 1.25 95% CI 1.1-1.5, P = .007), planned cesarean delivery (OR 1.34, 95% CI 1.1-1.7, P = .009), 1-minute Apgar scores 7-8 ( OR 1.22, 95% CI 1.1-1.4, P = .008) and less than 7 (OR 1.34, 95% CI 1.03-1.8, P = .032), and neonatal intensive care unit treatment (OR 1.52, 95% CI 1.2-2.0, P = .003). Asperger syndrome was associated only with 1-minute Apgar scores 7-8 (OR 1.19, 95% CI 1.03-1.4, P = .018).
Conclusions
Low Apgar scores as well as conditions requiring neonatal special follow-up are important risk factors for childhood autism and PDD. These findings suggest that fetal distress is a potential risk factor for these disorders, but not for Asperger syndrome.