Saemundsen Evald, Ludvigsson Petur, Rafnsson Vilhjalmur
State Diagnostic and Counseling Center, Division of Autism and Communication Disorders, Kopavogur, Iceland.
Epilepsia. 2008 Nov;49(11):1865-70. doi: 10.1111/j.1528-1167.2008.01688.x. Epub 2008 Jun 13.
No population-based study has investigated the risk of autism spectrum disorders (ASDs) in children after unprovoked seizures with onset in the first year of life. Our objective was to determine whether infantile spasms were related to risk of ASD as compared to unprovoked seizures with onset in the first year of life after adjusting for symptomatic origin of seizures.
This is a population-based case-control study nested in a cohort of children with unprovoked seizures in the first year of life. The cohort comprised 95 children, 34 boys and 61 girls. Cases were defined as children with ASD, controls were without ASD, and exposure was a history of infantile spasms. The Mantel-Haenszel test and logistic regression were used to calculate the odds ratio (OR) and 95% confidence intervals (CI).
The crude OR for ASD associated with infantile spasms was 5.53 (95% CI 1.25-23.06). Stratification on age and gender did not change the OR. The OR for ASD associated with infantile spasms adjusted for symptomatic seizures was 1.55 (95% CI 0.33-7.37), while the OR for ASD associated with symptomatic seizures adjusted for infantile spasms was 8.73 (95% CI 1.88-40.54). Restriction to mental age 24 months or higher yielded higher ORs.
Infantile spasms predicted high risk for ASD, but this was to a large extent explained by the association of ASD with symptomatic origin of seizures.
尚无基于人群的研究调查过出生后第一年发生无诱因癫痫发作的儿童患自闭症谱系障碍（ASD）的风险。我们的目标是在调整癫痫发作的症状性起源后，确定与出生后第一年发生无诱因癫痫发作相比，婴儿痉挛症是否与ASD风险相关。
这是一项基于人群的病例对照研究，嵌套于一组出生后第一年发生无诱因癫痫发作的儿童队列中。该队列包括95名儿童，34名男孩和61名女孩。病例定义为患有ASD的儿童，对照为无ASD的儿童，暴露因素为婴儿痉挛症病史。采用Mantel-Haenszel检验和逻辑回归计算比值比（OR）和95%置信区间（CI）。
与婴儿痉挛症相关的ASD的粗OR为5.53（95%CI 1.25 - 23.06）。按年龄和性别分层后OR未改变。调整症状性癫痫发作后，与婴儿痉挛症相关的ASD的OR为1.55（95%CI 0.33 - 7.37），而调整婴儿痉挛症后，与症状性癫痫发作相关的ASD的OR为8.73（95%CI 1.88 - 40.54）。将心理年龄限制在24个月及以上时，OR更高。
婴儿痉挛症预示着ASD的高风险，但这在很大程度上可由ASD与癫痫发作的症状性起源之间的关联来解释。
