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自闭症谱系障碍儿童共患神经发育障碍的预测因素

Predictors of Co-occurring Neurodevelopmental Disabilities in Children With Autism Spectrum Disorders.

作者信息

Zauche Lauren Head, Darcy Mahoney Ashley E, Higgins Melinda K

机构信息

Emory University Nell Hodgson Woodruff School of Nursing, 1520 Clifton Rd NE, Atlanta, GA 30322, United States.

George Washington University, Autism and Neurodevelopmental Disorders Institute, 2121 Eye Street NW, Washington, D.C. 20052, United States.

出版信息

J Pediatr Nurs. 2017 Jul-Aug;35:113-119. doi: 10.1016/j.pedn.2017.04.002. Epub 2017 Apr 13.

Abstract

PURPOSE

Co-occurring neurodevelopmental disabilities (including cognitive and language delays and attention deficit hyperactivity disorder) affect over half of children with ASD and may affect later behavioral, language, and cognitive outcomes beyond the ASD diagnosis. However, no studies have examined predictors of co-occurring neurodevelopmental disabilities in children with ASD. This study investigated whether maternal sociodemographic, perinatal and neonatal factors are associated with co-occurring disabilities.

DESIGN AND METHODS

This study involved a retrospective analysis of medical records for children diagnosed with ASD between 2009 and 2010 at an Autism Center in the southeast United States. Logistic regression was used to identify predictors of co-occurring neurodevelopmental disabilities.

RESULTS

Of the 385 children in the sample, 61% had a co-occurring neurodevelopmental disability. Children whose mothers had less education (OR: 0.905), had never been married (OR: 1.803), or had bleeding during pregnancy (OR: 2.233) were more likely to have a co-occurring neurodevelopmental disability. Both preterm birth and African American race were associated with bleeding during pregnancy.

CONCLUSIONS

Several maternal and perinatal risk factors for ASD were found to put children at risk for further diagnoses of co-occurring neurodevelopmental disabilities. While prematurity, a well-established risk factor for ASD, as well as maternal ethnicity was not found to increase the risk of a co-occurring disability, this study suggests that bleeding during pregnancy may moderate these relationships.

PRACTICE IMPLICATIONS

Understanding maternal, perinatal, and neonatal risk factors may inform healthcare provider screening for ASD and co-occurring neurodevelopmental disabilities by helping providers recognize infants who present with multiple risk factors.

摘要

目的

共病的神经发育障碍(包括认知和语言发育迟缓以及注意力缺陷多动障碍)影响超过半数的自闭症谱系障碍(ASD)儿童,并且可能影响ASD诊断之外的后期行为、语言和认知结果。然而,尚无研究探讨ASD儿童中共病神经发育障碍的预测因素。本研究调查了母亲的社会人口统计学、围产期和新生儿因素是否与共病障碍相关。

设计与方法

本研究对美国东南部一家自闭症中心2009年至2010年期间诊断为ASD的儿童的病历进行回顾性分析。采用逻辑回归来确定共病神经发育障碍的预测因素。

结果

样本中的385名儿童中,61%患有共病神经发育障碍。母亲受教育程度较低(比值比:0.905)、从未结婚(比值比:1.803)或孕期出血(比值比:2.233)的儿童更有可能患有共病神经发育障碍。早产和非裔美国人种族均与孕期出血有关。

结论

发现ASD的几个母亲和围产期风险因素会使儿童面临进一步诊断为共病神经发育障碍的风险。虽然早产这一已明确的ASD风险因素以及母亲种族并未被发现会增加共病障碍的风险,但本研究表明孕期出血可能会缓和这些关系。

实践意义

了解母亲、围产期和新生儿风险因素可能有助于医疗保健提供者筛查ASD和共病神经发育障碍,通过帮助提供者识别具有多种风险因素的婴儿。

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