Lyall Kristen, Croen Lisa, Daniels Julie, Fallin M Daniele, Ladd-Acosta Christine, Lee Brian K, Park Bo Y, Snyder Nathaniel W, Schendel Diana, Volk Heather, Windham Gayle C, Newschaffer Craig
A.J. Drexel Autism Institute, Philadelphia, Pennsylvania 19104; email:
Kaiser Permanente Division of Research, Oakland, California 94612.
Annu Rev Public Health. 2017 Mar 20;38:81-102. doi: 10.1146/annurev-publhealth-031816-044318. Epub 2016 Dec 21.
Autism spectrum disorder (ASD) is a complex neurodevelopmental condition with lifelong impacts. Genetic and environmental factors contribute to ASD etiology, which remains incompletely understood. Research on ASD epidemiology has made significant advances in the past decade. Current prevalence is estimated to be at least 1.5% in developed countries, with recent increases primarily among those without comorbid intellectual disability. Genetic studies have identified a number of rare de novo mutations and gained footing in the areas of polygenic risk, epigenetics, and gene-by-environment interaction. Epidemiologic investigations focused on nongenetic factors have established advanced parental age and preterm birth as ASD risk factors, indicated that prenatal exposure to air pollution and short interpregnancy interval are potential risk factors, and suggested the need for further exploration of certain prenatal nutrients, metabolic conditions, and exposure to endocrine-disrupting chemicals. We discuss future challenges and goals for ASD epidemiology as well as public health implications.
自闭症谱系障碍（ASD）是一种复杂的神经发育疾病，会产生终身影响。遗传和环境因素都对ASD的病因有所影响，而我们对此仍未完全了解。在过去十年中，关于ASD流行病学的研究取得了重大进展。据估计，发达国家目前的患病率至少为1.5%，近期患病率上升主要集中在那些没有合并智力残疾的人群中。基因研究已经确定了一些罕见的新生突变，并在多基因风险、表观遗传学和基因与环境相互作用等领域取得了进展。针对非遗传因素的流行病学调查已将父母高龄和早产确定为ASD的风险因素，表明产前接触空气污染和怀孕间隔时间短是潜在风险因素，并建议进一步探索某些产前营养素、代谢状况以及接触内分泌干扰化学物质的情况。我们讨论了ASD流行病学未来面临的挑战和目标以及对公共卫生的影响。
