Impact of caesarean delivery on children's autism-like behaviours: the mediation of exclusive breastfeeding.
Impact of caesarean delivery on children's autism-like behaviours: the mediation of exclusive breastfeeding.
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剖腹产对儿童自闭症样行为的影响：纯母乳喂养的中介作用
DOI：
10.1186/s13006-022-00493-6
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发表时间：
2022-07-15
影响因子：
3.5
通讯作者：
中科院分区：
文献类型：
--
作者：
自闭症谱系障碍（ASD）的发病率在全球范围内呈上升趋势，因此确定ASD的潜在病因以促进早期预防非常重要。本研究探讨了母乳喂养的作用以及剖宫产（CD）与儿童自闭症谱系障碍之间的关联。
数据来自中国马鞍山出生队列（MABC），该队列于2013年5月至2014年9月建立。招募了孕周在14周以内的女性。分娩方式从医疗记录中提取，婴儿喂养情况通过问卷调查获得。在儿童18个月和3岁时，使用幼儿自闭症检查表（CHAT - 23）评估自闭症样行为。在5岁时，使用克兰西自闭症行为量表评估自闭症样行为。结构方程模型检验了母乳喂养在剖宫产与儿童自闭症谱系障碍之间的中介效应。
总共有1520名（48.89%）女性通过剖宫产分娩，在18个月时，有406名（13.86%）儿童被确定有自闭症样行为。与顺产的女性相比，剖宫产的女性更有可能出现较高比例的延迟开始母乳喂养（p < 0.01）和延迟泌乳（p < 0.01）。剖宫产与产后4个月纯母乳喂养的比例较低有关（p = 0.02）。4个月时纯母乳喂养的婴儿比4个月时非纯母乳喂养的婴儿出现自闭症样行为的可能性更低（p < 0.01）。结构方程模型表明，剖宫产的女性更有可能在头4个月停止纯母乳喂养（标准估计值 = - 0.04，p = 0.02），4个月时未纯母乳喂养的儿童更有可能出现自闭症样行为（标准估计值 = - 0.05，p < 0.01）。这种关联在3岁时仍然存在，但在5岁时不存在。
4个月时的纯母乳喂养介导了剖宫产与儿童自闭症样行为之间的关联。
网络版包含补充材料，可在10.1186/s13006 - 2022 - 00493 - 6获取。
The rate of autism spectrum disorder (ASD) has been rising worldwide, and therefore it is important to identify potential causes of ASD to facilitate early prevention. This study examined the role of breastfeeding and the association between caesarean delivery (CD) and children’s autism spectrum disorder. The data were from the Ma’anshan birth cohort (MABC) in China, that was set up between May 2013 and September 2014. Women within 14 gestational weeks were recruited. The delivery mode was extracted from medical notes and infant feeding was obtained from questionnaire surveys. Autism-like behaviour was assessed using the Checklist for Autism in Toddlers (CHAT-23) when children were 18 months old, and 3 years of age. At 5 years of age, autism-like behaviour was assessed using the Clancy Autism Behavior Scale behavior. Structural equation models tested the mediation effects of breastfeeding between CD and children’s autism spectrum disorder. In all, 1520 (48.89%) women gave birth via CD, and 406 (13.86%) children were identified with autism-like behaviours at 18 months. Compared with women giving birth via vaginal delivery, those giving birth via CD were more likely to experience a higher proportion of delayed initiation of breastfeeding (p < 0.01), and delayed onset of lactogenesis (p < 0.01). CD was associated with a lower proportion of exclusive breastfeeding at 4 months after delivery (p = 0.02). Autism-like behaviour was less likely amongst infants with exclusively breastfeeding at 4 months than amongst those not exclusively breastfeeding at 4 months (p < 0.01). SEM indicated that women who gave birth by CD were more likely to stop exclusive breastfeeding in the first 4 months (standard estimations = − 0.04, p = 0.02), and those children who were not exclusively breastfed at 4 months were more likely to have autism-like behaviours (standard estimations = − 0.05, p < 0.01). The associations persisted at 3 years, but not at 5 years. Exclusive breastfeeding at 4 months of age mediated the association between caesarean delivery and children’s autism-like behaviours. The online version contains supplementary material available at 10.1186/s13006-022-00493-6.
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影响因子：
1.9
作者：
Deng, Wenlin;Zou, Xiaobing;Guo, Xiaobo
通讯作者：
Guo, Xiaobo
影响因子：
4
作者：
Andoy Galvan JA;Ramalingam PN;Patil SS;Bin Shobri MAS;Chinna K;Sahrir MS;Chidambaram K
通讯作者：
Chidambaram K
DOI：
10.15585/mmwr.ss6706a1
发表时间：
2018-04-27
期刊：
Morbidity and mortality weekly report. Surveillance summaries (Washington, D.C. : 2002)
影响因子：
--
作者：
Baio J;Wiggins L;Christensen DL;Maenner MJ;Daniels J;Warren Z;Kurzius-Spencer M;Zahorodny W;Robinson Rosenberg C;White T;Durkin MS;Imm P;Nikolaou L;Yeargin-Allsopp M;Lee LC;Harrington R;Lopez M;Fitzgerald RT;Hewitt A;Pettygrove S;Constantino JN;Vehorn A;Shenouda J;Hall-Lande J;Van Naarden Braun K;Dowling NF
通讯作者：
Dowling NF
DOI：
10.1111/j.1471-0528.2005.00548.x
发表时间：
2005-07-01
影响因子：
5.8
作者：
Jordan, S;Emery, S;Friswell, W
通讯作者：
Friswell, W
剖腹产对产后最初四个月的母乳喂养开始，持续时间和困难的影响。
影响因子：
3.1
作者：
Hobbs AJ;Mannion CA;McDonald SW;Brockway M;Tough SC
通讯作者：
Tough SC