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怀孕母亲的医疗索赔及其子女被诊断为自闭症谱系障碍的相关风险。

Pregnant Mothers' Medical Claims and Associated Risk of Their Children being Diagnosed with Autism Spectrum Disorder.

作者信息

Grivas Genevieve, Frye Richard, Hahn Juergen

机构信息

Department of Biomedical Engineering, Rensselaer Polytechnic Institute, Troy, New York, NY 12180, USA.

Center for Biotechnology and Interdisciplinary Studies, Rensselaer Polytechnic Institute, Troy, New York, NY 12180, USA.

出版信息

J Pers Med. 2021 Sep 24;11(10):950. doi: 10.3390/jpm11100950.

Abstract

A retrospective analysis of administrative claims containing a diverse mixture of ages, ethnicities, and geographical regions across the United States was conducted in order to identify medical events that occur during pregnancy and are associated with autism spectrum disorder (ASD). The dataset used in this study is comprised of 123,824 pregnancies of which 1265 resulted in the child being diagnosed with ASD during the first five years of life. Logistic regression analysis revealed significant relationships between several maternal medical claims, made during her pregnancy and segmented by trimester, and the child's diagnosis of ASD. Having a biological sibling with ASD, maternal use of antidepressant medication and psychiatry services as well as non-pregnancy related claims such hospital visits, surgical procedures, and radiology exposure were related to an increased risk of ASD regardless of trimester. Urinary tract infections during the first trimester and preterm delivery during the second trimester were also related to an increased risk of ASD. Preventative and obstetrical care were associated with a decreased risk for ASD. A better understanding of the medical factors that increase the risk of having a child with ASD can lead to strategies to decrease risk or identify those children who require increased surveillance for the development of ASD to promote early diagnosis and intervention.

摘要

为了确定孕期发生的且与自闭症谱系障碍(ASD)相关的医学事件,我们对包含美国不同年龄、种族和地理区域的行政索赔进行了回顾性分析。本研究使用的数据集包括123,824例妊娠,其中1265例导致孩子在生命的前五年被诊断为ASD。逻辑回归分析显示,在孕期提出的、按孕期划分的多项孕产妇医疗索赔与孩子的ASD诊断之间存在显著关系。有患ASD的亲兄弟姐妹、孕产妇使用抗抑郁药物和接受精神病学服务,以及与妊娠无关的索赔,如医院就诊、外科手术和放射学暴露,无论处于哪个孕期,都与ASD风险增加有关。孕早期的尿路感染和孕中期的早产也与ASD风险增加有关。预防保健和产科护理与ASD风险降低有关。更好地了解增加孩子患ASD风险的医学因素,可以制定降低风险的策略,或识别那些需要加强ASD发育监测的儿童,以促进早期诊断和干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e57/8537202/f32c88fdb9f5/jpm-11-00950-g001.jpg

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