Kawa Rafal, Saemundsen Evald, Lóa Jónsdóttir Sigrídur, Hellendoorn Annika, Lemcke Sanne, Canal-Bedia Ricardo, García-Primo Patricia, Moilanen Irma
Polish Academy of Sciences, ul. Jaracza 1, Warszawa 00-378, Poland.
The State Diagnostic and Counselling Centre, Digranesvegur 5, 200 Kópavogur, Iceland.
Eur J Public Health. 2017 Feb 1;27(1):101-110. doi: 10.1093/eurpub/ckw206.
Autism spectrum disorders (ASDs), once considered to be rare, are now reaching prevalence estimates of 1% and higher. Studies conducted in North America indicate large racial/ethnic disparities in the diagnosis of ASDs. Others show, that immigrant children have similar prevalence rates of ASDs as native children, although they are diagnosed later compared with native children. In relation to a EU funded network action, Enhancing the Scientific Study of Early Autism, it was considered important to review the literature on this subject.
A comprehensive literature search was undertaken for original articles reporting on prevalence and risk for ASD in Europe among immigrants and ethnic minorities and data across studies were compared.
Seventeen studies conducted in Europe concerning immigrants and ethnic minorities were found. Fifteen studies suggest a higher prevalence rate of ASDs among children of immigrants in comparison to native children (RR = 1.02-1.74; OR = 0.6-10.5). One study revealed higher prevalence of autism (OR = 2.2; 95% CI 1.6-3.1) and lower prevalence of Asperger syndrome in immigrants (OR = 0.6; 95% CI 0.3-0.97). One study showed a lower prevalence of Asperger syndrome in immigrants (aOR = 0.1, 95% CI 0.01-0.5). The majority of those analyses involved immigrants from outside Europe, e.g. from Africa and South America.
After analysing the results of studies conducted in Europe, it is unclear if higher prevalence estimates of ASDs among immigrants in this region reflect true differences, especially considering many potential confounding factors, e.g. genetic, biological, environmental and cultural. Considering the number of people migrating within Europe there is a substantial need to study further the prevalence of ASDs in immigrant groups.
自闭症谱系障碍（ASD）曾被认为较为罕见，如今其患病率估计已达1%及以上。在北美进行的研究表明，ASD诊断存在巨大的种族/族裔差异。其他研究显示，移民儿童的ASD患病率与本地儿童相似，尽管他们比本地儿童确诊时间晚。关于欧盟资助的网络行动“加强早期自闭症科学研究”，审查该主题的文献被认为很重要。
对报道欧洲移民和少数族裔中ASD患病率及风险的原始文章进行全面文献检索，并比较各项研究的数据。
发现了17项在欧洲针对移民和少数族裔进行的研究。15项研究表明，与本地儿童相比，移民儿童的ASD患病率更高（相对危险度=1.02 - 1.74；比值比=0.6 - 10.5）。一项研究显示，移民中自闭症患病率较高（比值比=2.2；95%置信区间1.6 - 3.1），阿斯伯格综合征患病率较低（比值比=0.6；95%置信区间0.3 - 0.97）。一项研究表明，移民中阿斯伯格综合征患病率较低（校正比值比=0.1，95%置信区间0.01 - 0.5）。这些分析大多涉及来自欧洲以外地区的移民，如非洲和南美洲。
在分析欧洲开展的研究结果后，尚不清楚该地区移民中较高的ASD患病率估计是否反映了真实差异，尤其是考虑到许多潜在的混杂因素，如遗传、生物学、环境和文化因素。鉴于欧洲内部的移民数量，迫切需要进一步研究移民群体中ASD的患病率。
