Department of Biomedical Engineering, Rensselaer Polytechnic Institute, Troy, New York, USA.
Center for Biotechnology and Interdisciplinary Studies, Rensselaer Polytechnic Institute, Troy, New York, USA.
Autism Res. 2022 Nov;15(11):2038-2055. doi: 10.1002/aur.2809. Epub 2022 Sep 6.
Previous work identified three subgroups of children with ASD based upon co-occurring conditions (COCs) diagnosed during the first 5 years of life. This work examines prenatal risk factors, given by maternal medical claims, for each of the three subgroups: children with a High-Prevalence of COCs, children with mainly developmental delay and seizures (DD/Seizure COCs), and children with a Low-Prevalence of COCs. While some risk factors are shared by all three subgroups, the majority of the factors identified for each subgroup were unique; infections, anti-inflammatory and other complex medications were associated with the High-Prevalence COCs group; immune deregulatory conditions such as asthma and joint disorders were associated with the DD/Seizure COCs group; and overall pregnancy complications were associated with the Low-Prevalence COCs group. Thus, we have found that the previously identified subgroups of children with ASD have distinct associated prenatal risk factors. As such, this work supports subgrouping children with ASD based upon COCs, which may provide a framework for elucidating some of the heterogeneity associated with ASD.
先前的工作基于儿童生命早期 5 年内的共病（COC）诊断，确定了 ASD 的三个亚组。本研究检查了每个亚组的产前风险因素，这些因素是通过母体医疗索赔确定的：高 COC 发生率的儿童、主要表现为发育迟缓伴癫痫（DD/Seizure COC）的儿童以及 COC 发生率低的儿童。虽然所有三个亚组都有一些共同的风险因素，但为每个亚组确定的大多数因素都是独特的；感染、抗炎和其他复杂药物与高 COC 发生率组有关；哮喘和关节疾病等免疫失调疾病与 DD/Seizure COC 组有关；而整体妊娠并发症与低 COC 发生率组有关。因此，我们发现先前确定的 ASD 儿童亚组具有不同的相关产前风险因素。因此，本研究支持基于 COC 对 ASD 儿童进行分组，这可能为阐明与 ASD 相关的一些异质性提供框架。
