Nishigori Toshie, Hashimoto Koichi, Mori Miyuki, Suzuki Taeko, Watanabe Madoka, Imaizumi Karin, Murata Tsuyoshi, Kyozuka Hyo, Ogata Yuka, Sato Akiko, Shinoki Kosei, Yasumura Seiji, Fujimori Keiya, Nishigori Hidekazu, Hosoya Mitsuaki
Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan.
Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan.
J Dev Orig Health Dis. 2023 Feb;14(1):70-76. doi: 10.1017/S2040174422000411. Epub 2022 Jul 8.
Maternal prenatal psychological distress, which includes depression and anxiety, affects the onset of autism spectrum disorder (ASD). However, there is no consistent knowledge regarding at which term during pregnancy psychological distress affects the risk of ASD among children. We used a dataset obtained from the Japan Environment and Children's Study, which is a nationwide prospective birth cohort study, to evaluate the association between the six-item Kessler Psychological Distress Scale (K6) and ASD among 3-year-old children. A total of 78,745 children were analyzed, and 355 of them were diagnosed with ASD (0.45%). The maternal K6 was administered twice during pregnancy: at a median of 15.1 weeks (M-T1) and at that of 27.4 weeks (M-T2) of gestation. Multivariate logistic regression analyses demonstrated that the group with a maternal K6 score of ≥5 at both M-T1 and M-T2 was significantly associated with ASD among the children (adjusted odds ratio, 1.440; 95% confidence interval, 1.104-1.877) compared to the group with a score of ≤4 at both M-T1 and M-T2. There was no significant difference between the group with a score of ≥5 only at M-T1 or M-T2 and that with a score of ≤4 at both M-T1 and M-T2. In conclusion, from the first to the second half of pregnancy, continuous maternal psychological distress was associated with ASD among 3-year-old children. Contrarily, in the group without persistent maternal psychological distress during pregnancy, there was no significant association.
孕产妇产前心理困扰，包括抑郁和焦虑，会影响自闭症谱系障碍（ASD）的发病。然而，关于孕期哪个阶段心理困扰会影响儿童患ASD的风险，目前尚无一致的认识。我们使用了从日本环境与儿童研究中获得的数据集，这是一项全国性的前瞻性出生队列研究，以评估6项凯斯勒心理困扰量表（K6）与3岁儿童ASD之间的关联。总共分析了78745名儿童，其中355名被诊断为ASD（0.45%）。孕期对母亲进行了两次K6测试：妊娠中期为15.1周（M-T1），妊娠27.4周（M-T2）。多变量逻辑回归分析表明，与M-T1和M-T2得分均≤4的组相比，M-T1和M-T2时母亲K6得分均≥5的组与儿童ASD显著相关（调整后的优势比为1.440；95%置信区间为1.104-1.877）。仅在M-T1或M-T2时得分≥5的组与M-T1和M-T2时得分均≤4的组之间无显著差异。总之，从妊娠前半期到后半期，母亲持续的心理困扰与3岁儿童的ASD相关。相反，在孕期没有母亲持续心理困扰的组中，没有显著关联。
