Gao Lei, Xi Qian Qian, Wu Jun, Han Yu, Dai Wei, Su Yuan Yuan, Zhang Xin
Dept. Maternal, Child & Adolescence Health of School of Public Health, Tianjin Medical University, Tianjin 300070, China.
Program in Public Health and department of Epidemiology, University of California, Irvine, USA.
Biomed Environ Sci. 2015 Sep;28(9):642-50. doi: 10.3967/bes2015.090.
To investigate the association between autism and prenatal environmental risk factors.
A case-control study was conducted among 193 children with autism from the special educational schools and 733 typical development controls matched by age and gender by using questionnaire in Tianjin from 2007 to 2012. Statistical analysis included quick unbiased efficient statistical tree (QUEST) and logistic regression in SPSS 20.0.
There were four predictors by QUEST and the logistic regression analysis, maternal air conditioner use during pregnancy (OR=0.316, 95% CI: 0.215-0.463) was the single first-level node (χ²=50.994, P=0.000); newborn complications (OR=4.277, 95% CI: 2.314-7.908) and paternal consumption of freshwater fish (OR=0.383, 95% CI: 0.256-0.573) were second-layer predictors (χ²=45.248, P=0.000; χ²=24.212, P=0.000); and maternal depression (OR=4.822, 95% CI: 3.047-7.631) was the single third-level predictor (χ²=23.835, P=0.000). The prediction accuracy of the tree was 89.2%.
The air conditioner use during pregnancy and paternal freshwater fish diet might be beneficial for the prevention of autism, while newborn complications and maternal depression might be the risk factors.
探讨自闭症与产前环境危险因素之间的关联。
2007年至2012年期间,在天津市采用问卷调查法,对来自特殊教育学校的193名自闭症儿童以及733名年龄和性别相匹配的正常发育儿童进行了病例对照研究。统计分析采用SPSS 20.0中的快速无偏有效统计树(QUEST)和逻辑回归分析。
通过QUEST和逻辑回归分析得出四个预测因素,孕期母亲使用空调(OR = 0.316,95%CI:0.215 - 0.463)是唯一的一级节点(χ² = 50.994,P = 0.000);新生儿并发症(OR = 4.277,95%CI:2.314 - 7.908)和父亲食用淡水鱼(OR = 0.383,95%CI:0.256 - 0.573)是二级预测因素(χ² = 45.248,P = 0.000;χ² = 24.212,P = 0.000);母亲抑郁(OR = 4.822,95%CI:3.047 - 7.631)是唯一的三级预测因素(χ² = 23.835,P = 0.000)。该树状模型的预测准确率为89.2%。
孕期母亲使用空调和父亲食用淡水鱼可能有助于预防自闭症,而新生儿并发症和母亲抑郁可能是危险因素。