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需要新生儿重症监护的儿童自闭症的潜在风险因素。

Potential Risk Factors for Autism in Children Requiring Neonatal Intensive Care Unit.

机构信息

Department of Neuropediatrics, Children's Hospital Pequeno Príncipe, Waldemar Monastier Hospital, Curitiba, Brazil.

Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba, Brazil.

出版信息

Neuropediatrics. 2021 Aug;52(4):284-293. doi: 10.1055/s-0041-1726401. Epub 2021 Apr 14.

Abstract

BACKGROUND

The etiology of autism spectrum disorder (ASD) is complex and involves the interplay of genetic and environmental factors.

AIM

We sought to identify potential prenatal, perinatal, and neonatal risk factors for ASD in a unique population of children who had perinatal complications and required care in a neonatal intensive care unit (NICU).

METHODS

This prospective cohort study included 73 patients discharged from a NICU who received long-term follow-up at the largest children's hospital in Brazil. Potential risk factors were compared between 44 children with a diagnosis of ASD and 29 children without using the Mann-Whitney test. Proportions were analyzed using the chi-square test. Simple and multiple logistic regression tests were performed.

RESULTS

Of 38 factors analyzed, the following 7 were associated with ASD: family history of neuropsychiatric disorders ( = 0.049); maternal psychological distress during pregnancy ( = 0.007); ≥ 26 days in the NICU ( = 0.001); feeding tube for ≥ 15 days ( = 0.014); retinopathy of prematurity ( = 0.022); use of three or more antibiotics ( = 0.008); and co-sleeping until up to 2 years of age ( = 0.004).

CONCLUSION

This study found associations between specific risk factors during critical neurodevelopmental periods and a subsequent diagnosis of ASD. Knowledge of the etiologic factors that may influence the development for ASD is paramount for the development of intervention strategies and improvement of prognoses.

摘要

背景

自闭症谱系障碍(ASD)的病因复杂,涉及遗传和环境因素的相互作用。

目的

我们试图在一个有围产期并发症并需要在新生儿重症监护病房(NICU)接受治疗的独特儿童群体中,确定 ASD 的潜在产前、围产期和新生儿危险因素。

方法

这项前瞻性队列研究纳入了 73 名从 NICU 出院并在巴西最大的儿童医院接受长期随访的患儿。使用 Mann-Whitney 检验比较了 44 名被诊断为 ASD 的患儿和 29 名无 ASD 的患儿之间的潜在危险因素。使用卡方检验分析比例。进行简单和多因素逻辑回归检验。

结果

在分析的 38 个因素中,以下 7 个因素与 ASD 相关:神经精神障碍家族史( = 0.049);妊娠期间母亲心理困扰( = 0.007);NICU 住院时间≥26 天( = 0.001);使用喂养管≥15 天( = 0.014);早产儿视网膜病变( = 0.022);使用≥3 种抗生素( = 0.008);以及与父母同睡至 2 岁( = 0.004)。

结论

这项研究发现了在关键神经发育时期特定危险因素与随后 ASD 诊断之间的关联。了解可能影响 ASD 发生的病因因素对于制定干预策略和改善预后至关重要。

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