Elgen Silje Katrine Fevang, Røiseland Madland Ada, Bircow Elgen Irene, Vollsæter Maria, Hysing Mari
Department of Pediatrics, Haukeland University Hospital, Bergen, Norway.
Department of Child and Adolescent Psychiatry, Haukeland University Hospital, Bergen, Norway.
Eur Child Adolesc Psychiatry. 2023 Sep;32(9):1579-1588. doi: 10.1007/s00787-022-01953-4. Epub 2022 Mar 10.
The objective of this study is to investigate the prevalence of autism (ASD) symptoms, i.e. , social difficulties, repetitive behaviors, and communicational problems, among children born extremely preterm (EP) compared to a reference group, and to investigate possible antecedents of ASD symptoms among EP children. Method is a national Norwegian cohort of 11 year old EP children, excluding those with intellectual disabilities, non-ambulatory cerebral palsy, blindness, and/or deafness. Parents and teachers reported ASD symptoms using The Autism Spectrum Screening Questionnaire (ASSQ). Social difficulties, repetitive behaviors, communicational problems, and a total ASSQ score were presented. Combined ratings on the ASSQ was defined as parent and/or teacher scoring the child ≥ 98th percentile of the reference group, which was the population-based Bergen Child Study. Of eligible children, 216 (64%) EP and 1882 (61%) reference children participated. EP children had significantly higher mean scores and combined ratings on social difficulties (14.5% vs. 4.1%, OR: 3.2), repetitive behaviors (23.7% vs. 4.0%, OR: 6.4), communicational problems (23.1% vs. 4.8%, OR: 5.4), and the total ASSQ score (18.3% vs. 3.4%, OR: 5.7) compared to reference children. Only no prenatal steroids, IQ 70-84, and mental health problems at 5 years of age were significantly associated with ASD symptoms at 11 years of age. EP children were at increased risk of social difficulties, repetitive behaviors, and communicational problems, and approximately one out of five were reported as high scorers of ASD symptoms. No prenatal steroids use, IQ in the lower range, and mental health problems at 5 years of age were associated with ASD symptoms.
本研究的目的是调查极早产儿（EP）与参照组儿童相比，自闭症（ASD）症状（即社交困难、重复行为和沟通问题）的患病率，并调查极早产儿中ASD症状可能的先兆因素。研究方法是挪威全国范围内对11岁极早产儿的队列研究，排除有智力残疾、非行走型脑瘫、失明和/或失聪的儿童。家长和教师使用《自闭症谱系筛查问卷》（ASSQ）报告ASD症状。呈现了社交困难、重复行为、沟通问题以及ASSQ总分。ASSQ的综合评分定义为家长和/或教师对儿童的评分≥参照组第98百分位数，参照组是基于人群的卑尔根儿童研究。在符合条件的儿童中，216名（64%）极早产儿和1882名（61%）参照组儿童参与了研究。与参照组儿童相比，极早产儿在社交困难（14.5%对4.1%，比值比：3.2）、重复行为（23.7%对4.0%，比值比：6.4）、沟通问题（23.1%对4.8%，比值比：5.4）以及ASSQ总分（18.3%对3.4%，比值比：5.7）方面的平均得分和综合评分显著更高。只有未使用产前类固醇、智商70 - 84以及5岁时存在心理健康问题与11岁时的ASD症状显著相关。极早产儿出现社交困难、重复行为和沟通问题的风险增加，约五分之一的极早产儿被报告为ASD症状高分者。未使用产前类固醇、较低范围的智商以及5岁时的心理健康问题与ASD症状相关。
