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[儿童自闭症谱系障碍的环境风险因素]

[Environmental risk factors for autism spectrum disorders in children].

作者信息

Liu Dan, Zhan Jian-Ying, Shao Jie

机构信息

Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2015 Nov;17(11):1147-53.

Abstract

OBJECTIVE

To investigate the environmental risk factors for autism spectrum disorders (ASD) in children.

METHODS

In this case-control study, 81 boys with ASD, 74 boys with global developmental delay (GDD), and 163 healthy boys were enrolled. A self-designed nurturing environment questionnaire was used to record general demographic data, family social-economic status, parents' living habits and environmental exposure, maternal health status during pregnancy, birth situations, and rearing environment after birth. Multivariate logistic regression was used to identify environmental risk factors for ASD and GDD.

RESULTS

Multivariate logistic regression analysis showed that six environmental risk factors such as maternal occupational toxicant exposure, diseases during pregnancy and a history of passive smoking, children's birth places, the frequency of outdoor activities in the second year after birth, and the opportunities to communicate with other age-matched children were significantly associated with the incidence of ASD (OR=20.67, 3.559, 2.422, 2.646, 23.820, and 5.081, respectively; P<0.05). Among the above six risk factors, passive smoking during pregnancy, the opportunities to communicate with their peers, and the frequency of outdoor activities in the second year after birth were also significantly associated with the incidence of GDD (P<0.05).

CONCLUSIONS

Maternal occupational toxicant exposure, diseases during pregnancy, and low level of children's birth places may be the specific risk factors associated with ASD, and passive smoking during pregnancy, fewer opportunities to communicate with their peers, and fewer outdoor activities in the second year after birth are non-specific risk factors for ASD, indicating that the development of ASD may be influenced by both genes and environmental factors.

摘要

目的

探讨儿童自闭症谱系障碍(ASD)的环境危险因素。

方法

在这项病例对照研究中,纳入了81名患有ASD的男孩、74名患有全面发育迟缓(GDD)的男孩和163名健康男孩。使用自行设计的养育环境问卷记录一般人口统计学数据、家庭社会经济状况、父母的生活习惯和环境暴露情况、孕期母亲的健康状况、出生情况以及出生后的养育环境。采用多因素logistic回归分析确定ASD和GDD的环境危险因素。

结果

多因素logistic回归分析显示,母亲职业性毒物暴露、孕期疾病和被动吸烟史、孩子的出生地、出生后第二年的户外活动频率以及与其他年龄匹配儿童交流的机会等六个环境危险因素与ASD的发病率显著相关(OR分别为20.67、3.559、2.422、2.646、23.820和5.081;P<0.05)。在上述六个危险因素中,孕期被动吸烟、与同龄人交流的机会以及出生后第二年的户外活动频率也与GDD的发病率显著相关(P<0.05)。

结论

母亲职业性毒物暴露、孕期疾病以及孩子出生地较低可能是与ASD相关的特定危险因素,孕期被动吸烟、与同龄人交流机会较少以及出生后第二年户外活动较少是ASD的非特定危险因素,表明ASD的发生可能受基因和环境因素的共同影响。

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