Gyamenah Prince, Burrows Kimberley, Rai Dheeraj, Joinson Carol
Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Bristol Medical School, University of Bristol, Bristol, UK.
J Autism Dev Disord. 2024 Dec 7. doi: 10.1007/s10803-024-06663-1.
There is evidence that children with autism/autistic traits have higher risks of incontinence and constipation, but no studies have examined this in a large community-based cohort. Aim/Research question: are autistic traits and diagnosed autism prospectively associated with increased odds of incontinence and constipation in children and adolescents? This was a population-based cohort study based on data from the Avon Longitudinal Study of Parents and Children (n = 4233-4490 at age 9 years; n = 3403-3697 at age 14). We used multivariable logistic regression to examine associations of parent-reported autistic traits (sociability, repetitive behaviours, social-communication, coherence) (at ages 3-9 years) and autism with incontinence (bedwetting, daytime-wetting, soiling) and constipation (parent-reported at age 9, self-reported at age 14). We adjusted for parity, maternal age at delivery, child's sex and developmental level, maternal depression, and anxiety (antenatal and postnatal), and indicators of family socioeconomic status. Social-communication and speech coherence difficulties showed the strongest associations with incontinence, e.g., adjusted odds ratio (OR) and 95% confidence interval (CI) for the association between social-communication difficulties and daytime-wetting was 2.21 (1.47-3.32) and for coherence was 2.34 (1.60-3.43). The odds of soiling were also higher in children with social-communication (OR: 1.88, 95% CI 1.28-2.75) and coherence difficulties (OR: 2.04, 95% CI 1.43-2.93). Diagnosed autism was only associated with an increase in the odds of daytime-wetting (OR: 3.18, 95% CI 1.44-7.02). At 14 years, there was less evidence of associations between autistic traits and incontinence but there was evidence of associations between autistic traits and constipation: social-communication (OR: 1.68, 95% CI 1.13-2.49), coherence difficulties (OR: 1.64, 95% CI 1.11-2.41). Early assessment and treatment of incontinence/constipation should be considered for children with autistic traits.
有证据表明，患有自闭症/具有自闭症特征的儿童出现大小便失禁和便秘的风险更高，但尚无研究在大规模社区队列中对此进行调查。目的/研究问题：自闭症特征和确诊的自闭症与儿童及青少年大小便失禁和便秘几率增加是否存在前瞻性关联？这是一项基于人群的队列研究，数据来自雅芳亲子纵向研究（9岁时n = 4233 - 4490；14岁时n = 3403 - 3697）。我们使用多变量逻辑回归来研究父母报告的自闭症特征（社交能力、重复行为、社交沟通、连贯性）（3至9岁）和自闭症与大小便失禁（尿床、日间遗尿、弄脏）及便秘（9岁时父母报告，14岁时自我报告）之间的关联。我们对胎次、产妇分娩年龄、孩子性别和发育水平、产妇抑郁和焦虑（产前和产后）以及家庭社会经济地位指标进行了调整。社交沟通和言语连贯性困难与大小便失禁的关联最为显著，例如，社交沟通困难与日间遗尿之间关联的调整优势比（OR）和95%置信区间（CI）为2.21（1.47 - 3.32），连贯性困难与日间遗尿之间关联的调整优势比为2.34（1.60 - 3.43）。社交沟通困难（OR：1.88，95% CI 1.28 - 2.75）和连贯性困难（OR：2.04，95% CI 1.43 - 2.93）的儿童弄脏的几率也更高。确诊的自闭症仅与日间遗尿几率增加相关（OR：3.18，95% CI 1.44 - 7.02）。在14岁时，自闭症特征与大小便失禁之间关联的证据较少，但有证据表明自闭症特征与便秘之间存在关联：社交沟通（OR：1.68，95% CI 1.13 - 2.49），连贯性困难（OR：1.64，95% CI 1.11 - 2.41）。对于具有自闭症特征的儿童，应考虑对大小便失禁/便秘进行早期评估和治疗。
