Autism spectrum disorder is associated with ventricular enlargement in a low birth weight population.
Autism spectrum disorder is associated with ventricular enlargement in a low birth weight population.
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DOI：
10.1016/j.jpeds.2012.12.084
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发表时间：
2013-07
期刊：
影响因子：
--
通讯作者：
Paneth N
中科院分区：
文献类型：
--
作者：
Movsas TZ;Pinto-Martin JA;Whitaker AH;Feldman JF;Lorenz JM;Korzeniewski SJ;Levy SE;Paneth N
旨在确定低出生体重 (LBW) 成年幸存者（自闭症谱系障碍风险增加的人群）中新生儿颅骨超声异常与自闭症谱系障碍 (ASD) 的关系。这是对 1105 名 LBW 婴儿的前瞻性跟踪区域出生队列的二次分析，在出生后第一周通过头颅超声系统地筛查围产期脑损伤，随后使用两阶段过程评估自闭症谱系障碍 [16 岁时筛查 (N=623)，随后在 21 岁时对系统选择的筛查亚组 (N=189) 进行诊断评估]；已发现 14 例自闭症谱系障碍 (ASD) 病例。在本分析中，颅超声异常被定义为脑室扩大（指示弥漫性白质损伤）、实质病变（指示局灶性白质损伤）和孤立的生发基质/脑室内出血（GM/IVH）。与无颅脑超声异常相比，任何类型的白质损伤（脑室扩大和/或实质病变）使 ASD 筛查呈阳性的风险增加三倍 [3.0 ( 2.2, 4.1)]。然而，被诊断为自闭症谱系障碍的风险取决于白质损伤的类型。脑室扩大时，ASD 诊断的风险几乎是无颅超声异常的 7 倍 [6.7 (2.3, 19.7)]，并且没有发现脑室扩大的实质病变风险升高 [1.8 (0.2, 13.6)]。孤立的 GM/IVH 不会增加 ASD 筛查或诊断阳性的风险。在 LBW 新生儿中，脑室扩大的头颅超声证据是随后发展为严格诊断的 ASD 的强有力且重要的危险因素。
To determine the relation of neonatal cranial ultrasound abnormalities to autism spectrum disorders (ASD) in low birthweight (LBW) adult survivors, a population at increased ASD risk. This is a secondary analysis of a prospectively-followed regional birth cohort of 1105 LBW infants systematically screened for perinatal brain injury with cranial ultrasound in the first week of life and later assessed for ASD using a two-stage process [screening at age 16 years (N=623) followed by diagnostic assessment at age 21 years of a systematically selected subgroup of those screened (N=189)]; 14 cases of ASD were identified. For this analysis, cranial ultrasound abnormalities were defined as ventricular enlargement (indicative of diffuse white matter injury), parenchymal lesions (indicative of focal white matter injury) and isolated germinal matrix/intraventricular hemorrhage (GM/IVH). Compared with no cranial ultrasound abnormalities, any type of white matter injury (ventricular enlargement and/or parenchymal lesion) tripled the risk for screening positively for ASD [3.0 ( 2.2, 4.1)]. However, the risk of being diagnosed with ASD depended on type of white matter injury. With ventricular enlargement, the risk of ASD diagnosis was almost seven-fold that of no cranial ultrasound abnormality [6.7 (2.3, 19.7)], and no elevated risk was found for parenchymal lesion without ventricular enlargement [1.8 (0.2, 13.6)]. Isolated GM/IVH did not increase risk for a positive ASD screen or diagnosis. In LBW neonates, cranial ultrasound evidence of ventricular enlargement is a strong, and significant risk factor for subsequent development of rigorously-diagnosed ASD.
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