Predictors of autism including low birth weight and social cognitive impairment: a longitudinal epidemiological study

没有研究成功地建立了预测自闭症谱系障碍（ASD）的早期前兆。为了在文献中提出的行为和社会背景中确定这些前兆，我们于2007年11月建立了一项出生队列研究：滨松母亲和儿童出生队列研究（HBC研究），其中涉及1，200多名母亲和婴儿，目前正在进行随访。在随访至32个月的参与儿童（N=549）中，24例被诊断为ASD的一致诊断。在使用混合模型的分析中，我们发现，发育里程碑包括坐着，对联合注意的反应，对“给我”的适当反应，光学翻正反射，双手的操纵使用，在10个月和14个月时，预测ASD在32个月时的诊断。然后，我们将这些前兆结合起来制定诊断算法，灵敏度为88%，特异性为83%。我们的结论是，使用5个发育里程碑，这并不局限于众所周知的社会认知领域，在1岁左右的ASD的早期预测诊断是可能的。

No study has succeeded in establishing very early precursors for predicting autism spectrum disorder (ASD). To establish such precursors in behavioural as well as social context suggested in literature, we founded a birth cohort study in November, 2007: Hamamatsu Birth Cohort Study for Mothers and Children (HBC Study), in which more than 1,200 mother-and-infant dyads are involved and are currently followed-up. Among the participating children followed-up by the age of 32 months (N=549), 24 were diagnosed to have a consensus diagnosis of ASD. In the analyses using mixed modeling , we found that developmental milestones including sitting, response to joint attention, appropriate response to “Give it to me”, optical righting reflex, manipulative use of both hands, at the age of 10 months and14 months, are predictive of ASD diagnosis at the age of 32 months. Then, we combined these precursors to formulate a diagnostic algorithm, and resulted in sensitivity of 88% and specificity of 83%. We concluded that, using 5 developmental milestones, which are not confined in the well-known socialcognition domain, early predictive diagnosis of ASD at the age of around 1 year is possible.