Piven J, Simon J, Chase G A, Wzorek M, Landa R, Gayle J, Folstein S
Department of Psychiatry, Johns Hopkins University, School of Medicine, Baltimore, MD.
J Am Acad Child Adolesc Psychiatry. 1993 Nov;32(6):1256-63. doi: 10.1097/00004583-199311000-00021.
To examine pre-, peri-, and neonatal factors in autism using composite optimality scores.
Pre-, peri-, and neonatal composite optimality scores were examined in 39 autistic subjects and 39 randomly matched sibling controls using a modification of the Gillberg Optimality Scale (Modified-GOS). Scores were based on best-estimate ratings of maternal interviews and medical records. Rules for best-estimate ratings were derived from a study of agreement between these two sources.
Significant differences in optimality between autistic probands and their siblings were not present after adjustment for "maternal parity." Examination of specific variables revealed that only maternal parity differed significantly between autistic subjects and randomly matched sibling controls, reflecting an excess of first and fourth born among the autistic subjects.
The findings of this study suggest that previous reports of an association between optimality and autism are a result of failure to adjust for birth order.
使用综合最优性评分来研究自闭症的产前、围产期和新生儿因素。
采用改良的吉尔伯格最优性量表（Modified-GOS），对39名自闭症患者和39名随机匹配的同胞对照进行产前、围产期和新生儿综合最优性评分。评分基于对母亲访谈和病历的最佳估计评级。最佳估计评级规则源自对这两个来源之间一致性的研究。
在对“母亲生育次数”进行调整后，自闭症先证者与其同胞之间的最优性没有显著差异。对特定变量的检查显示，自闭症患者与随机匹配的同胞对照之间仅母亲生育次数存在显著差异，这反映出自闭症患者中头胎和第四胎出生的比例过高。
本研究结果表明，先前关于最优性与自闭症之间关联的报道是未对出生顺序进行调整的结果。
