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自闭症谱系障碍的产前、围产期、产后危险因素和过度屏幕时间。

Prenatal, perinatal, postnatal risk factors, and excess screen time in autism spectrum disorder.

机构信息

Department of Psychology, Istanbul Gelisim University, Istanbul, Turkey.

Department of Child and Adolescent Psychiatry, Bakirkoy Training and Research Hospital for Mental Health and Neurological Disorders, Istanbul, Turkey.

出版信息

Pediatr Int. 2023 Jan;65(1):e15383. doi: 10.1111/ped.15383.

Abstract

BACKGROUND

The aim of this study was to investigate pre-, peri-, and postnatal factors, screen time in a group of patients with autism spectrum disorder (ASD) and age and sex-matched clinical controls to evaluate risk factors specific to ASD.

METHODS

The study included 211 ASD patients (177 boys, 34 girls; mean age 44.3 ± 13.0 months) and 241 (190 boys, 51 girls; mean age 44.6 ± 14.1 months) age and sex group matched clinical controls. Non-ASD diagnoses were expressive language disorder (n = 135, 56.0%), intellectual disability (n = 15, 6.2%), attention deficit-hyperactivity disorder (n = 6, 2.4%), oppositional disorder (n = 6, 2.4%), and other behavioral or emotional problems (no diagnosis; n = 79, 32.8%). A sociodemographic data form was used to collect data regarding pre-, peri-, and postnatal factors and total daily screen exposure.

RESULTS

According to our findings, maternal severe psychological stress and depression during pregnancy, and maternal postpartum depression were more frequent in the ASD group (p = 0.005, p = 0.035, and p = 0.001 respectively). There was a statistically significant difference between groups with regards to maternal any medication use during pregnancy (p = 0.004). The mean duration of daily screen exposure was higher in the ASD group (9.90 ± 5.10 h) compared to non-ASD children (4.46 ± 3.40 h; p < 0.001). A ROC curve showed that 8.5 h and above total daily screen exposure (AUC = 0.808 [95% CI: 0.769-0.848], p < 0.001; 55% sensitivity, 90.5% specificity) is likely to be associated with increased risk for ASD.

CONCLUSION

Our study suggests that prenatal maternal psychological stress, prenatal and postpartum depression, and excess exposure to screen might be related to an increased risk for ASD.

摘要

背景

本研究旨在调查自闭症谱系障碍(ASD)患者的产前、围产期和产后因素,以及与年龄和性别匹配的临床对照组的屏幕时间,以评估与 ASD 相关的特定风险因素。

方法

该研究纳入了 211 名 ASD 患者(177 名男孩,34 名女孩;平均年龄 44.3±13.0 个月)和 241 名(190 名男孩,51 名女孩;平均年龄 44.6±14.1 个月)年龄和性别匹配的临床对照组。非 ASD 诊断包括表达性语言障碍(n=135,56.0%)、智力障碍(n=15,6.2%)、注意力缺陷多动障碍(n=6,2.4%)、对立障碍(n=6,2.4%)和其他行为或情绪问题(无诊断;n=79,32.8%)。使用社会人口统计学数据表格收集有关产前、围产期和产后因素以及总日屏幕暴露的数据。

结果

根据我们的发现,母亲在怀孕期间严重的心理压力和抑郁,以及产后抑郁在 ASD 组更为常见(p=0.005,p=0.035,p=0.001)。两组之间在母亲怀孕期间使用任何药物方面存在统计学显著差异(p=0.004)。ASD 组的日屏幕暴露时间中位数高于非 ASD 儿童(9.90±5.10 h 与 4.46±3.40 h;p<0.001)。ROC 曲线显示,总日屏幕暴露时间超过 8.5 小时(AUC=0.808 [95%CI:0.769-0.848],p<0.001;55%的敏感性,90.5%的特异性)可能与 ASD 风险增加相关。

结论

本研究表明,产前母亲心理压力、产前和产后抑郁以及过度暴露于屏幕可能与 ASD 风险增加有关。

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