根据 DSM-5 标准诊断的自闭症谱系障碍在越南南部学龄前儿童中的流行情况及相关因素。

Prevalence of autism spectrum disorder diagnosed according to DSM-5 criteria and associated factors in preschoolers in southern Vietnam.

机构信息

Doctoral Program, Department of Psychiatry, Hanoi Medical University, Hanoi, Vietnam.

Institute of Mental Health, Bach Mai Hospital, Hanoi, Vietnam.

出版信息

Clin Ter. 2024 Nov-Dec;175(6):405-411. doi: 10.7417/CT.2024.5147.

DOI:10.7417/CT.2024.5147

PMID:39584760

Abstract

INTRODUCTION

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder that has become a significant concern in pediatric mental health due to its rising prevalence in recent years. Despite this increase, the prevalence of ASD and its associated risk factors remain poorly understood. This study aims to elucidate the prevalence of ASD and its associated risk factors among preschool children in southern Vietnam.

METHODS

This prospective study was conducted from June 2021 to December 2022 and included 9,397 children (4,813 boys and 4,584 girls) aged 24 to 72 months, attending 41 kindergartens in southern Vietnam. Diagnoses of ASD were made by qualified pediatric psychiatrists using DSM-5 criteria. Data on ASD-related variables were collected through a structured questionnaire administered by trained preschool teachers. Univariate logistic regression analysis was employed to identify associations between independent variables and the prevalence of ASD, followed by multivariate logistic regression models to control for potential confounders.

RESULTS

The overall prevalence of ASD among children aged 24 to 72 months attending preschool in southern Vietnam was found to be 1.2% (1 in 84 children). The prevalence rates in central, subcentral, and suburban areas were 2.00%, 0.6%, and 1%, respectively. Significant risk factors for ASD identified through multivariate regression analysis included age (24 to 30 months) with an odds ratio (OR) of 5.35 (95% CI: 2.84-10.10), male gender (OR=2.55, 95% CI: 1.68-3.86), maternal exposure to pesticides (OR=4.62, 95% CI: 1.84-11.61), maternal stress or psychological trauma during pregnancy (OR=2.3, 95% CI: 1.1-5.4).

CONCLUSION

ASD represents a significant pediatric psychiatric issue in southern Vietnam, with a higher incidence than previously reported. Some of the identified risk factors are potentially preventable, suggesting that targeted interventions could reduce the incidence of ASD.

摘要

引言

自闭症谱系障碍（ASD）是一种复杂的神经发育障碍，近年来其发病率不断上升，因此成为儿科心理健康领域的一个重要关注点。尽管如此，ASD 的患病率及其相关危险因素仍知之甚少。本研究旨在阐明越南南部学龄前儿童 ASD 的患病率及其相关危险因素。

方法

本前瞻性研究于 2021 年 6 月至 2022 年 12 月进行，纳入了 9397 名 24 至 72 个月龄、来自越南南部 41 所幼儿园的儿童（4813 名男孩和 4584 名女孩）。由合格的儿科精神科医生根据 DSM-5 标准诊断 ASD。通过由经过培训的学龄前教师进行的结构化问卷收集与 ASD 相关的变量数据。采用单变量逻辑回归分析识别自变量与 ASD 患病率之间的关联，然后采用多变量逻辑回归模型控制潜在混杂因素。

结果

在越南南部接受学前教育的 24 至 72 个月龄儿童中，ASD 的总体患病率为 1.2%（每 84 名儿童中有 1 名）。中心、次中心和郊区地区的患病率分别为 2.00%、0.6%和 1%。通过多变量回归分析确定的 ASD 显著危险因素包括年龄（24 至 30 个月），其比值比（OR）为 5.35（95%CI：2.84-10.10）、男性（OR=2.55，95%CI：1.68-3.86）、母亲在怀孕期间接触农药（OR=4.62，95%CI：1.84-11.61）、母亲在怀孕期间的压力或心理创伤（OR=2.3，95%CI：1.1-5.4）。