Department of Child Psychiatry, University of Turku, Turku, Finland.
J Pediatr. 2012 Nov;161(5):830-6. doi: 10.1016/j.jpeds.2012.04.058. Epub 2012 Jun 5.
To examine the relationship between birth weight, gestational age, small for gestational age (SGA), and 3 of the most common autism spectrum disorder (ASD) subtypes.
In this population-based case-control study conducted in Finland, 4713 cases born between 1987 and 2005 with International Classification of Diseases-diagnoses of childhood autism, Asperger syndrome, or pervasive developmental disorder (PDD), were ascertained from the Finnish Hospital Discharge Register. Four controls, individually matched on sex, date of birth, and place of birth, were selected from the Finnish Medical Birth Register for each case. Conditional logistic regression models were used to assess whether birth weight and gestational age information predicted ASD after controlling for maternal age, parity, smoking during pregnancy, and psychiatric history, as well as for infant's major congenital anomalies.
Very low (<1500 g) and moderately low (<2500 g) birth weight, very low gestational age (less than 32 weeks), and SGA increased risk of childhood autism (adjusted OR 3.05, 95% CI 1.4-6.5; 1.57, 1.1-2.3; 2.51, 1.3-5.0; and 1.72, 1.1-2.6, respectively). Very low and moderately low birth weight, very low gestational age, and SGA were also associated with increase in PDD risk (OR 3.44, 95% CI 1.9-6.3; 1.81, 1.4-2.4; 2.46, 1.4-2.3; and 2.24, 1.7-3.0, respectively). No associations were found between the perinatal characteristics and Asperger syndrome. The increased risks persisted after controlling for selected potential confounders.
The finding that low birth weight, prematurity, and SGA were related to childhood autism and PDD but not to Asperger syndrome suggests that prenatal factors related to these exposures may differ for these ASD subtypes, which may have preventive implications.
探讨出生体重、胎龄、小于胎龄儿（SGA）与三种最常见自闭症谱系障碍（ASD）亚型之间的关系。
本研究为基于人群的病例对照研究，在芬兰进行，共纳入 4713 例 1987 年至 2005 年间出生的患儿，这些患儿的国际疾病分类诊断为儿童自闭症、阿斯伯格综合征或广泛性发育障碍（PDD），并从芬兰住院患者登记处获得。每位病例均按性别、出生日期和出生地与芬兰医疗出生登记处选择 4 名单独匹配的对照。采用条件逻辑回归模型评估出生体重和胎龄信息是否能预测 ASD，同时控制了母亲年龄、产次、孕期吸烟以及精神病史，以及婴儿的主要先天畸形。
极低体重（<1500 克）和中度低体重（<2500 克）、极早产（<32 周）和 SGA 均增加儿童自闭症的发病风险（校正 OR 3.05，95%CI 1.4-6.5；1.57，1.1-2.3；2.51，1.3-5.0；1.72，1.1-2.6）。极低体重和中度低体重、极早产和 SGA 也与 PDD 风险增加相关（OR 3.44，95%CI 1.9-6.3；1.81，1.4-2.4；2.46，1.4-2.3；2.24，1.7-3.0）。围产期特征与阿斯伯格综合征之间无关联。在控制了选定的潜在混杂因素后，这些风险仍然存在。
低出生体重、早产和 SGA 与儿童自闭症和 PDD 相关，但与阿斯伯格综合征无关，这表明与这些 ASD 亚型相关的产前因素可能不同，这可能具有预防意义。
