Gynecology-Obstetrics Department, Mère-Enfant Hospital, University Hospital Center, Limoges, France.
BABiomedical, Luminy Scientific Campus, Marseille, France.
Sci Rep. 2021 Mar 25;11(1):6877. doi: 10.1038/s41598-021-86320-0.
To identify newborns at risk of developing ASD and to detect ASD biomarkers early after birth, we compared retrospectively ultrasound and biological measurements of babies diagnosed later with ASD or neurotypical (NT) that are collected routinely during pregnancy and birth. We used a supervised machine learning algorithm with a cross-validation technique to classify NT and ASD babies and performed various statistical tests. With a minimization of the false positive rate, 96% of NT and 41% of ASD babies were identified with a positive predictive value of 77%. We identified the following biomarkers related to ASD: sex, maternal familial history of auto-immune diseases, maternal immunization to CMV, IgG CMV level, timing of fetal rotation on head, femur length in the 3rd trimester, white blood cell count in the 3rd trimester, fetal heart rate during labor, newborn feeding and temperature difference between birth and one day after. Furthermore, statistical models revealed that a subpopulation of 38% of babies at risk of ASD had significantly larger fetal head circumference than age-matched NT ones, suggesting an in utero origin of the reported bigger brains of toddlers with ASD. Our results suggest that pregnancy follow-up measurements might provide an early prognosis of ASD enabling pre-symptomatic behavioral interventions to attenuate efficiently ASD developmental sequels.
为了识别有发展为 ASD 风险的新生儿,并在出生后尽早发现 ASD 的生物标志物,我们回顾性地比较了在怀孕期间和出生时常规收集的、后来被诊断为 ASD 或神经典型(NT)的婴儿的超声和生物测量结果。我们使用了一种带有交叉验证技术的监督机器学习算法来对 NT 和 ASD 婴儿进行分类,并进行了各种统计检验。在最小化假阳性率的情况下,96%的 NT 婴儿和 41%的 ASD 婴儿被正确识别,阳性预测值为 77%。我们确定了与 ASD 相关的以下生物标志物:性别、母体自身免疫性疾病家族史、母体对 CMV 的免疫接种、IgG CMV 水平、胎儿头部旋转的时间、孕晚期股骨长度、孕晚期白细胞计数、分娩时的胎儿心率、新生儿喂养方式以及出生和出生后一天之间的体温差。此外,统计模型表明,38%的 ASD 风险婴儿亚群的胎儿头围明显大于年龄匹配的 NT 婴儿,这表明报告的 ASD 幼儿大脑较大可能源于宫内起源。我们的研究结果表明,妊娠随访测量可能为 ASD 提供早期预后,从而能够进行症状前的行为干预来有效减轻 ASD 的发育后果。