Neonatal jaundice:: a risk factor for infantile autism?
Neonatal jaundice:: a risk factor for infantile autism?
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DOI：
10.1111/j.1365-3016.2008.00973.x
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发表时间：
2008-11-01
影响因子：
2.8
通讯作者：
Thorsen, Poul
中科院分区：
文献类型：
--
作者：
Maimburg, Rikke Damkjaer;Vaeth, Michael;Thorsen, Poul
在以前的一项研究中，我们发现，尽管对产科风险因素进行了广泛的控制，但分娩后转移到新生儿病房的婴儿在童年后期被诊断为自闭症的风险几乎增加了两倍。因此，我们决定调查其他原因转移到新生儿病房，特别是高胆红素血症和神经系统abnormality.We进行了一项基于人口的匹配病例对照研究，473名儿童自闭症和473名匹配的对照组出生于1990年至1999年在丹麦。病例为丹麦精神病中心登记处报告的诊断为幼儿自闭症的儿童。条件Logistic回归用于计算比值比（OR）和95%置信区间（CI），似然比检验用于检验效应修正，我们发现出生后有高胆红素血症的婴儿患自闭症的风险几乎是其4倍（OR 3.7 [95%CI 1.3，10.5]）。在分层分析中，这种关联似乎仅限于足月婴儿（>= 37周妊娠）。还观察到出生后异常神经系统体征与婴儿自闭症之间存在强相关性，尤其是高渗性（OR 6.7 [95% CI 1.5，29.7]）。未发现婴儿孤独症与低Apgar评分、酸中毒或低血糖之间存在关联。我们的研究结果表明，新生儿期的高胆红素血症和神经系统异常是研究婴儿自闭症原因时需要考虑的重要因素。
In a previous study, we found that infants transferred to a neonatal ward after delivery had an almost twofold increased risk of being diagnosed with infantile autism later in childhood in spite of extensive controlling of obstetric risk factors. We therefore decided to investigate other reasons for transfer to a neonatal ward, in particular hyperbilirubinaemia and neurological abnormalities.We conducted a population-based matched case-control study of 473 children with autism and 473 matched controls born from 1990 to 1999 in Denmark. Cases were children reported with a diagnosis of infantile autism in the Danish Psychiatric Central Register. Conditional logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals [CI] and likelihood ratio tests were used to test for effect modification.We found an almost fourfold risk for infantile autism in infants who had hyperbilirubinaemia after birth (OR 3.7 [95% CI 1.3, 10.5]). In stratified analysis, the association appeared limited to term infants (>= 37 weeks gestation). A strong association was also observed between abnormal neurological signs after birth and infantile autism, especially hypertonicity (OR 6.7 [95% CI 1.5, 29.7]). No associations were found between infantile autism and low Apgar scores, acidosis or hypoglycaemia. Our findings suggest that hyperbilirubinaemia and neurological abnormalities in the neonatal period are important factors to consider when studying causes of infantile autism.