Calo Psychiatric Center, Pingtung County, Taiwan.
Graduate Institute of Medical Science, National Defense Medical Center, Taipei, Taiwan.
Matern Child Health J. 2018 Jul;22(7):941-949. doi: 10.1007/s10995-018-2470-9.
Objective Previous studies have shown inconsistent results with regard to the association between advanced parental age and autism spectrum disorder (ASD). The sociodemographic status of parents has been found to be associated with children with ASD, however. Therefore, a pathway analysis was undertaken of the roles of maternal age and education in ASD diagnosis and community screening, in a national birth cohort database, using a propensity score matching (PSM) method. Method The 6- and 66-month Taiwan Birth Cohort Study dataset was used (N = 20,095). The PSM exact matching method was used to select 1700 families (ratio of 1:4 between ASD diagnosis and control) from the Taiwan Birth Cohort Study dataset. Results (1) The results from the complete dataset and the PSM exact matching dataset both show that the risk of a child being diagnosed with ASD was increased by the mother being over 40 years old. (2) Although more children of mothers with lower-than-average education were positive on screening, more children of mothers with higher-than-average education were also diagnosed with ASD. Conclusions for Practice Advanced maternal age had a higher association with the diagnosis of ASD, and maternal educational disparity was found between ASD clinical diagnosis and community screening. Community and primary medical care services should pay more attention to children of parents with lower education during ASD screening to prevent delayed diagnosis.
先前的研究表明,父母高龄与自闭症谱系障碍(ASD)之间的关联结果不一致。然而,父母的社会人口统计学状况与 ASD 患儿有关。因此,本研究采用倾向评分匹配(PSM)方法,在全国出生队列数据库中,对母亲年龄和教育在 ASD 诊断和社区筛查中的作用进行路径分析。
使用 6 个月和 66 个月的台湾出生队列研究数据集(N=20095)。PSM 精确匹配方法用于从台湾出生队列研究数据集中选择 1700 个家庭(ASD 诊断与对照组的比例为 1:4)。
(1)完整数据集和 PSM 精确匹配数据集的结果均表明,母亲年龄超过 40 岁会增加儿童被诊断为 ASD 的风险。(2)尽管母亲教育程度较低的儿童在筛查中阳性的比例较高,但母亲教育程度较高的儿童也被诊断为 ASD 的比例较高。
母亲高龄与 ASD 的诊断有更高的相关性,并且在 ASD 临床诊断和社区筛查之间发现了母亲教育的差异。社区和初级医疗保健服务机构在进行 ASD 筛查时应更加关注受教育程度较低的父母的子女,以防止诊断延误。