Rosen Nila J, Yoshida Cathleen K, Croen Lisa A
Division of Research, Kaiser Permanente, Oakland, California, USA.
Pediatrics. 2007 Jan;119(1):e61-9. doi: 10.1542/peds.2006-1788.
The purpose of this work was to investigate the association between infections in the first 2 years and subsequent diagnosis of autism spectrum disorders.
We conducted a case-control study among children born at Kaiser Permanente Northern California from 1995 to 1999. Case subjects (n = 403) were children with an autism diagnosis recorded in Kaiser Permanente databases. Control subjects (n = 2100) were randomly sampled from the remaining children without autism and frequency matched to case subjects on gender, birth year, and birth hospital. Information on infections and covariates were obtained from Kaiser Permanente and birth certificate databases.
Overall, infection diagnoses in the first 2 years of life were recorded slightly less often for children with autism than control children (95.0% vs 97.5%). Among specific diagnoses, upper respiratory infections were significantly less frequently diagnosed and genitourinary infections more frequently diagnosed in children with autism. In the first 30 days of life, the frequency of having an infection was slightly higher among children with autism (22.6% vs 18.7%).
Children with subsequent diagnoses of autism do not have more overall infections in the first 2 years of life than children without autism. Data suggest that children with autism may have modestly elevated rates of infection in the first 30 days and that, during the first 2 years, children with autism may be at higher risk for certain types of infections and lower risk for others. Additional studies that explore the associations between prenatal and early childhood infections and autism may help clarify the role of infection and the immune system in the etiology of autism spectrum disorder.
本研究旨在调查儿童出生后头两年内的感染情况与随后被诊断为自闭症谱系障碍之间的关联。
我们对1995年至1999年在北加利福尼亚州凯撒医疗机构出生的儿童进行了一项病例对照研究。病例组（n = 403）为在凯撒医疗机构数据库中有自闭症诊断记录的儿童。对照组（n = 2100）是从其余无自闭症的儿童中随机抽取的，并在性别、出生年份和出生医院方面与病例组进行频率匹配。感染及协变量信息来自凯撒医疗机构和出生证明数据库。
总体而言，自闭症儿童在出生后头两年内被记录的感染诊断略少于对照组儿童（95.0%对97.5%）。在具体诊断中，自闭症儿童上呼吸道感染的诊断频率显著较低，而泌尿生殖系统感染的诊断频率较高。在出生后的前30天，自闭症儿童感染的频率略高（22.6%对18.7%）。
随后被诊断为自闭症的儿童在出生后头两年内的总体感染情况并不比无自闭症的儿童更多。数据表明，自闭症儿童在出生后前30天的感染率可能略有升高，并且在出生后的头两年内，自闭症儿童可能患某些类型感染的风险较高，而患其他类型感染的风险较低。进一步探索产前和幼儿期感染与自闭症之间关联的研究可能有助于阐明感染和免疫系统在自闭症谱系障碍病因中的作用。
