Department of Public Health Sciences, Henry Ford Hospital, 1 Ford Place, Suite 3E, Detroit, MI 48202, USA.
Department of Family Medicine and Public Health Sciences, Wayne State University, 6135 Woodward Avenue, Detroit, MI 48202, USA.
Placenta. 2017 Sep;57:183-188. doi: 10.1016/j.placenta.2017.07.006. Epub 2017 Jul 8.
Research suggests that autism spectrum disorder (ASD) has its origins in utero. This study examines the association between evidence of placental histopathology and ASD.
Administrative claims data and medical records data were used to identify ASD cases (N = 55) and matched controls (N = 199) born at New York Methodist Hospital between 2007 and 2014 and subsequently seen in affiliated pediatrics clinics. Placentas from all births during this time period were reviewed as part of routine care. Data were analyzed using conditional logistic regression to account for the matched (gender, gestational age, and birth weight) design.
Acute placental inflammation, regardless of type was associated with an increased risk of ASD (odds ratio [OR] = 3.14, 95% CI = 1.39, 6.95). Chronic uteroplacental vasculitis (OR = 7.13; 95% CI = 1.17, 43.38), the fetal inflammatory response in the chorionic plate vessels (OR = 5.12; 95% CI = 2.02, 12.96), and maternal vascular malperfusion pathology (OR = 12.29; 95% CI = 1.37, 110.69) were associated with an increased risk of ASD. Placental villous edema was associated with a decreased risk of ASD (OR = 0.05; 95% CI = 0.0005, 0.42). In subanalyses among male placentas acute inflammation overall, fetal inflammatory response in the chorionic plate vessels, and maternal vascular malperfusion pathology remained significantly associated with an increased risk of ASD whereas placental villous edema remained associated with a decreased risk of ASD.
Histologic evidence of placental inflammation and maternal vascular malperfusion pathology are associated with ASD.
研究表明，自闭症谱系障碍（ASD）起源于子宫内。本研究探讨了胎盘组织病理学证据与 ASD 之间的关联。
使用行政索赔数据和病历数据，确定 2007 年至 2014 年期间在纽约卫理公会医院出生并随后在附属儿科诊所就诊的 ASD 病例（N=55）和匹配对照（N=199）。在此期间所有分娩的胎盘均作为常规护理的一部分进行检查。使用条件逻辑回归分析数据，以考虑匹配（性别、胎龄和出生体重）设计。
急性胎盘炎症（无论类型如何）与 ASD 风险增加相关（比值比[OR] = 3.14，95%置信区间[CI] = 1.39，6.95）。慢性绒毛膜胎盘血管炎（OR = 7.13；95% CI = 1.17，43.38）、绒毛膜板血管中的胎儿炎症反应（OR = 5.12；95% CI = 2.02，12.96）和母体血管功能不全病理学（OR = 12.29；95% CI = 1.37，110.69）与 ASD 风险增加相关。胎盘绒毛水肿与 ASD 风险降低相关（OR = 0.05；95% CI = 0.0005，0.42）。在男性胎盘的亚分析中，总体急性炎症、绒毛膜板血管中的胎儿炎症反应和母体血管功能不全病理学与 ASD 风险增加显著相关，而胎盘绒毛水肿仍与 ASD 风险降低相关。
胎盘炎症和母体血管功能不全病理学的组织学证据与 ASD 相关。
