Autism Spectrum Disorders in Extremely Preterm Children
Autism Spectrum Disorders in Extremely Preterm Children
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DOI：
10.1016/j.jpeds.2009.10.041
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发表时间：
2010-04-01
影响因子：
5.1
通讯作者：
Marlow, Neil
中科院分区：
文献类型：
--
作者：
Johnson, Samantha;Hollis, Chris;Marlow, Neil
研究设计我们对1995年在英国和爱尔兰出生的小于26周的早产儿进行了一项前瞻性研究。在307名11岁的幸存者中，有219名（71%）接受了评估，并与153名足月出生的同学进行了比较。父母完成了社会沟通问卷（SCQ），以评估自闭症谱系症状，并通过精神病学评估诊断ASD。还进行了IQ测试和临床评估。结果极早产儿的SCQ得分显著高于同班同学（平均差异为4.6分，95%CI为3.4-5.8）。16名极早产儿（8%）被诊断为ASD，而同学中没有一人被诊断为ASD。出院时，男性，低妊娠，阴道臀位分娩，异常脑超声扫描结果，没有母乳与自闭症谱系症状独立相关。到6年，独立的联营公司认知障碍，注意力不集中和同伴问题，撤回行为在2.5年，没有母乳。结论非常早产儿自闭症谱系症状和ASD在童年中期的风险增加。这些症状和障碍与神经认知结果相关，表明ASD可能是由于该人群的大脑发育异常所致。（J Pediatr 2010; 156：525-31）。
Objectives To investigate the prevalence, correlates, and antecedents of autism spectrum disorders (ASD) in extremely preterm children.Study design We conducted a prospective study of all births < 26 weeks gestation in the United Kingdom and Ireland in 1995. Of 307 survivors at 11 years, 219 (71%) were assessed and compared with 153 term-born classmates. Parents completed the Social Communication Questionnaire (SCQ) to assess autism spectrum symptoms, and ASD were diagnosed by using a psychiatric evaluation. An IQ test and clinical evaluation were also administered. Longitudinal outcome data were available for extremely preterm children.Results Extremely preterm children had significantly higher SCQ scores than classmates (mean difference, 4.6 points; 95% CI, 3.4-5.8). Sixteen extremely preterm children (8%) were assigned an ASD diagnosis, compared with none of the classmates. By hospital discharge, male sex, lower gestation, vaginal breech delivery, abnormal cerebral ultrasound scanning results, and not having had breast milk were independently associated with autism spectrum symptoms. By 6 years, independent associates were cognitive impairment, inattention and peer problems, withdrawn behavior at 2.5 years, and not having had breast milk.Conclusions Extremely preterm children are at increased risk for autism spectrum symptoms and ASD in middle childhood. These symptoms and disorders were associated with neurocognitive outcomes, suggesting that ASD may result from abnormal brain development in this population. (J Pediatr 2010; 156: 525-31).