New York State Institute for Basic Research in Developmental Disabilities, Department of Infant Development, 1050 Forest Hill Rd, Staten Island, NY 10314, USA.
Pediatrics. 2010 Sep;126(3):457-67. doi: 10.1542/peds.2009-2680. Epub 2010 Aug 2.
Recent evidence suggests higher prevalence of autism spectrum disorder (ASD) in NICU graduates. This aim of this study was to identify retrospectively early behaviors found more frequently in NICU infants who went on to develop ASD.
Twenty-eight NICU graduates who later received a diagnosis of ASD were compared with 2169 other NICU graduates recruited from 1994 to 2005. They differed in gender, gestational age, and birth cohort. These characteristics were used to draw a matched control sample (n=112) to determine which, if any, early behaviors discriminated subsequent ASD diagnosis. Behavioral testing at targeted ages (adjusted for gestation) included the Rapid Neonatal Neurobehavioral Assessment (hospital discharge, 1 month), Arousal-Modulated Attention (hospital discharge, 1 and 4 months), and Bayley Scales of Infant Development (multiple times, 4-25 months).
At 1 month, children with ASD but not control children had persistent neurobehavioral abnormalities and higher incidences of asymmetric visual tracking and arm tone deficits. At 4 months, children with ASD had continued visual preference for higher amounts of stimulation than did control children, behaving more like newborns. Unlike control children, children with ASD had declining mental and motor performance by 7 to 10 months, resembling infants with severe central nervous system involvement.
Differences in specific behavior domains between NICU graduates who later receive a diagnosis of ASD and matched NICU control children may be identified in early infancy. Studies with this cohort may provide insights to help understand and detect early disabilities, including ASD.
最近的证据表明，在新生儿重症监护病房（NICU）毕业的儿童中，自闭症谱系障碍（ASD）的患病率较高。本研究旨在回顾性地识别出在NICU 婴儿中更常见的早期行为，这些婴儿后来被诊断为 ASD。
将 28 名后来被诊断为 ASD 的 NICU 毕业生与 1994 年至 2005 年招募的 2169 名其他 NICU 毕业生进行比较。他们在性别、胎龄和出生队列方面存在差异。这些特征被用来绘制匹配的对照组样本（n=112），以确定哪些早期行为（如果有的话）可以区分随后的 ASD 诊断。在目标年龄（根据胎龄调整）进行的行为测试包括快速新生儿神经行为评估（出院时，1 个月）、觉醒调节注意（出院时，1 个月和 4 个月）和贝利婴幼儿发育量表（多次，4-25 个月）。
在 1 个月时，患有 ASD 的儿童但不是对照组儿童具有持续的神经行为异常和更高的不对称视觉跟踪和手臂张力缺陷发生率。在 4 个月时，与对照组儿童相比，患有 ASD 的儿童对更高刺激量的视觉偏好持续存在，行为更像新生儿。与对照组儿童不同，患有 ASD 的儿童在 7 至 10 个月时精神和运动表现持续下降，类似于患有严重中枢神经系统受累的婴儿。
在后来被诊断为 ASD 的 NICU 毕业生和匹配的 NICU 对照组儿童之间，可以在婴儿早期识别出特定行为领域的差异。对该队列的研究可能提供深入了解和早期发现残疾（包括 ASD）的机会。
