Prevalence and cumulative incidence of autism spectrum disorders and the patterns of co-occurring neurodevelopmental disorders in a total population sample of 5-year-old children
Prevalence and cumulative incidence of autism spectrum disorders and the patterns of co-occurring neurodevelopmental disorders in a total population sample of 5-year-old children
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DOI：
10.1186/s13229-020-00342-5
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发表时间：
2020-05-14
期刊：
影响因子：
6.2
通讯作者：
Nakamura, Kazuhiko
中科院分区：
文献类型：
--
作者：
Saito, Manabu;Hirota, Tomoya;Nakamura, Kazuhiko
背景自闭症谱系障碍（ASD）的频率是否真的增加仍不清楚。此外，在总人口样本中共存的神经发育障碍（NDD）的比率以前没有得到充分的研究。因此，使用日本的总人口样本，我们的目的是估计自闭症谱系障碍（ASD）的患病率和每年的累积发病率，以确定是否有一个真正的ASD患病率增加估计ASD每年的累积发病率，并检查共存的神经发育障碍（NDD）的比率。方法采用横断面序贯设计，对2013-2016年集水区5岁儿童进行筛查。筛查阳性的儿童被邀请参加综合评估，包括儿童和家长访谈，行为观察，认知和运动功能测试。所有病例均由一个多学科研究小组进行审查。结果3954名儿童的照顾者返回筛查，其中559名儿童接受评估，87名儿童接受ASD诊断。校正的ASD患病率为3.22%（95%置信区间（CI）2.66-3.76%）。男女粗患病率之比为2.2：1。在总研究年中，5岁以下ASD的累积发生率为1.31%（95% CI 1.00-1.62%）。广义线性模型显示，在研究年份中，5年累积发病率无显著线性趋势。只有11.5%的儿童单独患有ASD;其余88.5%的儿童被发现至少有一种共存的NDD。限制总人口研究的适度样本量。结论我们的研究结果表明ASD的5年累积发病率是稳定的，这意味着在研究集水区的4年研究期间ASD发病病例没有真正的上升。高比率的共存NDD反映了调查ASD儿童广泛发展挑战的重要性。
Backgrounds Whether there is a true increase in autism spectrum disorder (ASD) frequency or not remains unclear. Additionally, the rates of co-existing neurodevelopmental disorders (NDD) in a total population sample has not been fully examined before. Therefore, using a total population sample in Japan, we aimed to estimate the prevalence and cumulative incidence of autism spectrum disorder (ASD) annually, to determine whether there is a true increase in ASD prevalence by estimating the cumulative incidence of ASD annually, and to examine the rates of co-existing neurodevelopmental disorders (NDD). Method In this cross-sectional sequential design study, all 5-year-old children in the catchment area underwent the screening annually from the year 2013-2016. Screen-positive children were invited to participate in a comprehensive assessment, including child and parent interview, behavioral observation, and cognitive and motor function testing. All cases were reviewed by a multidisciplinary research team. Results Caregivers of 3954 children returned the screening, among which 559 children underwent the assessment with 87 children receiving an ASD diagnosis. Adjusted ASD prevalence was 3.22% (95% confidence interval (CI) 2.66-3.76%). The male to female ratio of the crude prevalence was 2.2:1. The cumulative incidence of ASD up to 5 years of age for the total study years was 1.31% (95% CI 1.00-1.62%). A generalized linear model revealed no significant linear trends in 5-year cumulative incidence over the study years. Only 11.5% of children had ASD alone; the remaining 88.5% were found to have at least one co-existing NDD. Limitations Modest sample size for a total population study. Conclusions Our findings demonstrate the stability of the 5-year cumulative incidence of ASD, implying no true rise in ASD incident cases over the 4-year study period in the study catchment area. High rates of co-existing NDDs reflect the importance of investigating broad developmental challenges in children with ASD.