Miller K M, Xing G, Walker C K
School of Medicine, University of California, Davis, Sacramento, CA, USA.
Center for Healthcare Policy and Research, University of California, Davis, Sacramento, CA, USA.
J Perinatol. 2017 Feb;37(2):203-207. doi: 10.1038/jp.2016.200. Epub 2016 Nov 3.
This study aims to determine whether fetal meconium passage is associated with autism.
This retrospective birth cohort analysis of 9 945 896 children born in California 1991 to 2008 linked discharge diagnosis and procedure codes for prenatal stressors, meconium-stained amniotic fluid (MSAF) and meconium aspiration syndrome (MAS) with autism diagnoses for 47 277 children through 2012. We assessed the relative risk of autism by meconium status using logistic regression, adjusting for demographic and clinical features.
Children exposed to meconium (MSAF and MAS) were more likely to be diagnosed with autism in comparison with unexposed children (0.60% and 0.52%, vs 0.47%, respectively). In adjusted analyses, there was a small increase in autism risk associated with MSAF exposure (adjusted relative risk (aRR) 1.18, 95% confidence interval (CI) 1.12 to 1.25), and a marginal association that failed to achieve significance between MAS and autism (aRR 1.08, 95% CI 0.98 to 1.20).
Resuscitation of neonates with respiratory compromise from in utero meconium exposure may mitigate long-term neurodevelopmental damage.
本研究旨在确定胎儿胎粪排出是否与自闭症有关。
这项对1991年至2008年在加利福尼亚州出生的9945896名儿童进行的回顾性出生队列分析，通过2012年将产前应激源、胎粪污染羊水（MSAF）和胎粪吸入综合征（MAS）的出院诊断及程序编码与47277名儿童的自闭症诊断相联系。我们使用逻辑回归评估了根据胎粪状况得出的自闭症相对风险，并对人口统计学和临床特征进行了调整。
与未接触胎粪的儿童相比，接触胎粪（MSAF和MAS）的儿童更有可能被诊断为自闭症（分别为0.60%和0.52%，对比0.47%）。在调整分析中，接触MSAF与自闭症风险略有增加相关（调整后相对风险（aRR）为1.18，95%置信区间（CI）为1.12至1.25），而MAS与自闭症之间存在边缘关联但未达到显著水平（aRR为1.08，95%CI为0.98至1.20）。
对因宫内胎粪暴露而出现呼吸功能不全的新生儿进行复苏可能会减轻长期神经发育损伤。
