DaWalt Leann Smith, Taylor Julie Lounds, Movaghar Arezoo, Hong Jinkuk, Kim Bryan, Brilliant Murray, Mailick Marsha R
Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA.
Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Autism Res. 2021 Sep;14(9):1896-1904. doi: 10.1002/aur.2563. Epub 2021 Jul 2.
The purpose of the present study was to investigate the hypothesis that women with autism have poorer health compared with men with autism, and compared with women without autism. Utilizing electronic health records drawn from a single health care system serving over 2 million individuals, 2119 adults with diagnosed autism spectrum disorders were compared with age- and sex-matched controls. When considering health care utilization, we found evidence of multiplicative risk for conditions within some domains (i.e., nutrition conditions, neurologic disease, psychiatric conditions, and sleep disorders) such that women with autism spectrum disorder (ASD) experienced double jeopardy-meaning they had greater rates of health care utilization within a domain than what would separately be expected by virtue of being a woman and having ASD. For other domains (i.e., endocrine disorders, gastrointestinal disorders), the risk was additive such that being a female and having ASD were both associated with higher health care utilization, but there were no significant interaction effects. It was only with respect to one domain (cardiovascular) that rates of health care utilization were reflective of neither ASD diagnosis nor sex. Overall, our findings suggest that women with ASD are a vulnerable subgroup with high levels of health care utilization. LAY SUMMARY: This study asked whether women with autism have poorer health compared with men with autism, and compared with women without autism. To answer this question, we used data from electronic health records. We found that women with autism spectrum disorder (ASD) were at the greatest risk for health problems such as nutrition conditions, neurologic disease, psychiatric conditions, and sleep disorders. More research on health of women with ASD is needed.
与患有自闭症的男性相比,以及与未患自闭症的女性相比,患有自闭症的女性健康状况更差。利用来自一个服务超过200万人的单一医疗系统的电子健康记录,将2119名被诊断为自闭症谱系障碍的成年人与年龄和性别匹配的对照组进行比较。在考虑医疗保健利用情况时,我们发现某些领域(即营养状况、神经疾病、精神疾病和睡眠障碍)内存在相乘风险的证据,即患有自闭症谱系障碍(ASD)的女性面临双重风险——这意味着她们在某一领域的医疗保健利用率高于因身为女性和患有ASD而分别预期的利用率。对于其他领域(即内分泌疾病、胃肠道疾病),风险是相加的,即身为女性和患有ASD都与更高的医疗保健利用率相关,但没有显著的交互作用。只有在一个领域(心血管),医疗保健利用率既不反映ASD诊断情况也不反映性别情况。总体而言,我们的研究结果表明,患有ASD的女性是一个医疗保健利用率高的脆弱亚组。通俗总结:本研究探讨了与患有自闭症的男性相比,以及与未患自闭症的女性相比,患有自闭症的女性健康状况是否更差。为回答这个问题,我们使用了电子健康记录中的数据。我们发现,患有自闭症谱系障碍(ASD)的女性面临营养状况、神经疾病、精神疾病和睡眠障碍等健康问题的风险最大。需要对患有ASD的女性的健康状况进行更多研究。