Autism risk in small- and large-for-gestational-age infants.

Autism risk in small- and large-for-gestational-age infants.
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DOI:
10.1016/j.ajog.2012.01.044
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发表时间:
2012-04
影响因子:
9.8
通讯作者:
--
中科院分区:
医学1区
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--
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我们试图确定小于胎龄(SGA)和大于胎龄(LGA)的出生体重是否会增加自闭症风险。这是一项回顾性队列分析,比较了出生队列(n = 5,979,605)中的自闭症儿童(n = 20,206)。按性别和出生体重百分位数(SGA,<第5或5- 10百分位数;适合胎龄的大小[GA],>第10至<第90百分位数; LGA,90- 95或>第95百分位数)分层,然后进行GA效应的Cochran-Mantel-Haenszel分析和多变量分析。早产儿SGA的自闭症风险增加(<第5百分位数)23-31周的婴儿(校正比值比[aOR],1.60; 95%置信区间[CI],1.09-2.35)和32-33周(aOR,1.83; 95% CI,1.16-2.87),和长期LGA(>第95百分位数)39-41周的婴儿(aOR,1.16; 95%CI,1.08-1.26),但在早产LGA婴儿23-31周时降低(aOR,0.45; 95%CI,0.21-0.95)。SGA与早产儿自闭症相关,而LGA表现出GA的二分风险,足月风险增加,早产儿风险降低。这些发现可能反映了不同的病理生理学,并应影响产前咨询,儿童自闭症筛查,和进一步的自闭症研究。
We sought to determine whether small-for-gestational age (SGA) and large-for-gestational age (LGA) birthweights increase autism risk. This was a retrospective cohort analysis comparing children with autism (n = 20,206) within a birth cohort (n = 5,979,605). Stratification by sex and birthweight percentile (SGA, <5th or 5–10th percentile; appropriate size for gestational age [GA], >10th to <90th percentile; LGA, either 90–95th or >95th percentile) preceded Cochran-Mantel-Haenszel analysis for GA effect, and multivariate analysis. Autism risk was increased in preterm SGA (<5th percentile) infants 23–31 weeks (adjusted odds ratio [aOR], 1.60; 95% confidence interval [CI], 1.09–2.35) and 32–33 weeks (aOR, 1.83; 95% CI, 1.16–2.87), and term LGA (>95th percentile) infants 39–41 weeks (aOR, 1.16; 95% CI, 1.08–1.26), but was decreased in preterm LGA infants 23–31 weeks (aOR, 0.45; 95% CI, 0.21–0.95). SGA was associated with autism in preterm infants, while LGA demonstrated dichotomous risk by GA, with increased risk at term, and decreased risk in the premature infants. These findings likely reflect disparate pathophysiologies, and should influence prenatal counseling, pediatric autism screening, and further autism research.
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