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孕期抑郁与儿童自闭症相关特征风险——“环境对儿童健康结果的影响”项目参与者研究

Prenatal depression and risk of child autism-related traits among participants in the Environmental influences on Child Health Outcomes program.

机构信息

Division of Research, Kaiser Permanente Northern California, Oakland, California, USA.

Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.

出版信息

Autism Res. 2023 Sep;16(9):1825-1835. doi: 10.1002/aur.2988. Epub 2023 Aug 1.

Abstract

This study evaluated the association between prenatal depression and offspring autism-related traits. The sample comprised 33 prenatal/pediatric cohorts participating in the Environmental influences on Child Health Outcomes program who contributed information on prenatal depression and autism-related traits. Autism-related traits were assessed continuously and at the diagnostic cut-off using the Social Responsiveness Scale for children up to 12 years of age. Main analyses included 3994 parent-child pairs with prenatal depression diagnoses data; secondary analyses included 1730 parent-child pairs with depression severity data. After confounder adjustment, we observed an increase in autism-related traits among children of individuals with prenatal depression compared to those without (adjusted β = 1.31 95% CI: 0.65, 1.98). Analyses stratified by child sex documented a similar significant association among boys (aβ = 1.34 95%CI: 0.36, 2.32) and girls (aβ = 1.26 95% CI: 0.37, 2.15). Prenatal depression was also associated with increased odds of moderate to severe autism-related traits (adjusted odds ratio: 1.64, 95%CI: 1.09, 2.46), the screening threshold considered high risk of autism spectrum disorder (ASD) diagnosis. Findings highlight the importance of prenatal depression screening and preventive interventions for children of pregnant individuals with depression to support healthy development. Future research is needed to clarify whether these findings reflect overlap in genetic risk for depression and ASD-related traits or another mechanism.

摘要

本研究评估了产前抑郁与后代自闭症相关特征之间的关联。样本包括参与环境对儿童健康结果影响计划的 33 个产前/儿科队列,这些队列提供了关于产前抑郁和自闭症相关特征的信息。自闭症相关特征通过儿童社交反应量表在 12 岁以下连续和在诊断截止点进行评估。主要分析包括 3994 对有产前抑郁诊断数据的父母-子女对;次要分析包括 1730 对有抑郁严重程度数据的父母-子女对。在调整混杂因素后,我们观察到与没有产前抑郁的个体相比,有产前抑郁的个体的后代自闭症相关特征增加(调整后的β=1.31,95%置信区间:0.65,1.98)。按儿童性别分层的分析记录了男孩(aβ=1.34,95%置信区间:0.36,2.32)和女孩(aβ=1.26,95%置信区间:0.37,2.15)中类似的显著关联。产前抑郁也与中度至重度自闭症相关特征的可能性增加相关(调整后的优势比:1.64,95%置信区间:1.09,2.46),这是被认为自闭症谱系障碍(ASD)诊断高风险的筛查阈值。研究结果强调了对有产前抑郁的孕妇进行产前抑郁筛查和预防干预的重要性,以支持儿童的健康发育。需要进一步的研究来阐明这些发现是否反映了抑郁和自闭症相关特征的遗传风险重叠,还是另一种机制。

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