Prenatal and perinatal risk factors and the clinical implications on autism spectrum disorder
Prenatal and perinatal risk factors and the clinical implications on autism spectrum disorder
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DOI：
10.1177/1362361318772813
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发表时间：
2019-04-01
期刊：
影响因子：
5.2
通讯作者：
Gau, Susan Shur-Fen
中科院分区：
文献类型：
--
作者：
Chien, Yi-Ling;Chou, Miao-Chun;Gau, Susan Shur-Fen
产前和围产期因素可能增加自闭症谱系障碍的风险。然而，对于先证子女患有自闭症谱系障碍的未受影响的兄弟姐妹是否也有这种现象，以及产前/围产期因素是否与自闭症症状的临床严重程度有关，我们知之甚少。我们比较了323名自闭症谱系障碍先证（平均年龄+/-标准差，10.7 +/- 3.5岁，男性，91.0%）、257名未受影响的兄弟姐妹（11.7 +/- 4.5岁，42.8%）和1504名典型发育对照（8.9 +/- 1.6岁，53.1%）的产前和围产期因素频率；并调查了它们对自闭症症状严重程度的影响。我们发现患有自闭症谱系障碍的先证者及其未受影响的兄弟姐妹比正常发育的对照组有更多的产前/围产期事件，先证者的产前/围产期因素数量高于未受影响的兄弟姐妹。产前/围产期事件与更大的刻板行为、社会情绪问题、社会沟通缺陷和整体严重程度有关。我们还发现六个产前/围产期因素（即先兆子痫、羊水过多、羊水过少、前置胎盘、脐带结和妊娠糖尿病）与自闭症症状的严重程度有关，特别是刻板行为和社会沟通缺陷。我们的研究结果表明，产前和围产期因素可能潜在地调节自闭症谱系障碍的临床表现。其潜在机制值得进一步研究。
Prenatal and perinatal factors may increase the risk of autism spectrum disorder. However, little is known about whether unaffected siblings of probands with autism spectrum disorder also share the phenomenon and whether the prenatal/perinatal factors are related to the clinical severity of autistic symptoms. We compared the frequency of prenatal and perinatal factors among 323 probands with autism spectrum disorder (mean age +/- standard deviation, 10.7 +/- 3.5 years; males, 91.0%), 257 unaffected siblings (11.7 +/- 4.5; 42.8%), and 1504 typically developing controls (8.9 +/- 1.6 years; 53.1%); and investigated their effects on the severity of autistic symptoms. We found that probands with autism spectrum disorder and their unaffected siblings had more prenatal/perinatal events than typically developing controls with higher numbers of prenatal/perinatal factors in probands than in unaffected siblings. The prenatal/perinatal events were associated with greater stereotyped behaviors, social-emotional problems, socio-communication deficits, and overall severity. We also found that six prenatal/perinatal factors (i.e. preeclampsia, polyhydramnios, oligoamnios, placenta previa, umbilical cord knot, and gestational diabetes) were associated with the severity of autistic symptoms, particularly stereotyped behaviors and socio-communication deficits. Our findings suggest that prenatal and perinatal factors may potentially moderate the clinical expression of autism spectrum disorder. The underlying mechanism warrants further research.