Karakter Child and Adolescent Psychiatry University Center, Nijmegen, The Netherlands.
Eur Child Adolesc Psychiatry. 2013 Jan;22(1):35-43. doi: 10.1007/s00787-012-0318-1. Epub 2012 Aug 26.
Pre/perinatal risk factors and body growth abnormalities have been studied frequently as early risk markers in autism spectrum disorder (ASD), yet their interrelatedness in ASD has received very little research attention. This is surprising, given that pre/perinatal risk factors can have a substantial impact on growth trajectories in the first years of life. We aimed to determine which pre/perinatal factors were more prevalent in ASD children and if these factors differentially influenced body growth in ASD and control children. A total of 96 ASD and 163 control children matched for gender participated. Data of growth of head size and body length during the first 13 months of life were collected. Data on pre/perinatal risk factors were retrospectively collected through standardized questionnaires. Results indicated that after matching for SES, prematurity/low birth weight and being first born were more prevalent in the ASD versus the control group. In addition, with increasing age children with ASD tended to have a proportionally smaller head circumference compared to their height. However, the effect of prematurity/low birth weight on head growth corrected for height was significantly different in ASD and control children: premature/low birth weight control children showed a disproportionate larger head circumference in relation to height during their first year of life, whereas this effect was absent in premature/low birth weight ASD children. This may suggest that the etiology of abnormal growth is potentially different in ASD and control children: where abnormal growth in control children is related to suboptimal conditions in the uterus, abnormal growth in ASD may be more strongly related to the causal factors that also increase the risk for ASD. However, prospective studies measuring growth and ASD characteristics in both premature/low birth weight and a terme children are necessary to support this conclusion.
围产期危险因素和身体生长异常经常被研究作为自闭症谱系障碍（ASD）的早期风险标志物，但它们在 ASD 中的相关性却很少受到关注。这令人惊讶，因为围产期危险因素会对生命最初几年的生长轨迹产生重大影响。我们旨在确定 ASD 儿童中哪些围产期因素更为普遍，以及这些因素是否会对 ASD 和对照组儿童的身体生长产生不同影响。共有 96 名 ASD 儿童和 163 名性别匹配的对照组儿童参与了这项研究。收集了他们在生命的前 13 个月中头围和体长的生长数据。通过标准化问卷回顾性收集了围产期危险因素的数据。结果表明，在匹配 SES 后，ASD 组中早产儿/低出生体重和第一胎的比例高于对照组。此外，随着年龄的增长，与身高相比，ASD 儿童的头围比例逐渐减小。然而，早产儿/低出生体重对身高校正后头围生长的影响在 ASD 和对照组儿童中存在显著差异：早产儿/低出生体重对照组儿童在生命的第一年中，头围相对于身高不成比例地增大，而这一效应在早产儿/低出生体重 ASD 儿童中则不存在。这可能表明 ASD 和对照组儿童异常生长的病因可能不同：在对照组儿童中，异常生长与子宫内环境不佳有关，而 ASD 中的异常生长可能与增加 ASD 风险的因果因素更为相关。然而，需要前瞻性研究来测量生长和 ASD 特征，以支持这一结论，包括早产儿/低出生体重和足月儿童。
