Department of Epidemiology, University of North Carolina at Chapel Hill, 116A South Merrit Mill, Chapel Hill, NC 27516, United States.
National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS E-86, Atlanta, GA 30333, United States.
Res Dev Disabil. 2018 Dec;83:168-178. doi: 10.1016/j.ridd.2018.08.015. Epub 2018 Sep 15.
Autism spectrumdisorder (ASD) commonly presents with co-occurring medical conditions (CoCs). Little is known about patterns in CoCs in a time of rising ASD prevalence.
To describe trends in number and type of documented CoCs in 8-year-old children with ASD.
We used Autism and Developmental Disabilities Monitoring Network (ADDM) data, a multi-source active surveillance system monitoring ASD prevalence among 8-year-old children across the US. Data from surveillance years 2002, 2006, 2008, and 2010 were used to describe trends in count, categories, and individual CoCs.
Mean number of CoCs increased from 0.94 CoCs in 2002 to 1.06 CoCs in 2010 (p < 0.001). The percentage of children with ASD with any CoC increased from 44.5% to 56.4% (p < 0.001). CoCs with the greatest increases were in general developmental disability (10.4% to 14.5%), language disorder (18.9% to 23.6%), and motor developmental disability (10.5% to 15.6%). Sex modified the relationship between developmental (P = 0.02) and psychiatric (P < 0.001) CoCs and surveillance year. Race/ethnicity modified the relationship between neurological conditions (P = 0.04) and surveillance year.
The increase in the percentage of children with ASD and CoCs may suggest the ASD phenotype has changed over time or clinicians are more likely to diagnose CoCs.
自闭症谱系障碍(ASD)常伴有共患疾病(CoC)。在 ASD 患病率上升的时期,关于 CoC 模式的了解甚少。
描述 ASD 儿童 8 岁时记录的 CoC 数量和类型的趋势。
我们使用自闭症和发育障碍监测网络(ADDM)的数据,这是一个多源主动监测系统,监测美国 8 岁儿童的 ASD 患病率。使用监测年份 2002、2006、2008 和 2010 年的数据来描述 CoC 的数量、类别和个体的趋势。
CoC 的平均数量从 2002 年的 0.94 个增加到 2010 年的 1.06 个(p<0.001)。患有 ASD 的儿童中有任何 CoC 的比例从 44.5%增加到 56.4%(p<0.001)。CoC 中增加最多的是一般发育障碍(10.4%至 14.5%)、语言障碍(18.9%至 23.6%)和运动发育障碍(10.5%至 15.6%)。性别修饰了发育(P=0.02)和精神(P<0.001)CoC 与监测年份之间的关系。种族/族裔修饰了神经系统疾病(P=0.04)与监测年份之间的关系。
患有 ASD 和 CoC 的儿童比例增加可能表明 ASD 表型随时间发生了变化,或者临床医生更有可能诊断 CoC。