孕产期及新生儿期危险因素与儿童孤独症关系的meta分析  

Risk factors for autism during perinatal and neonatal period:a meta-analysis

作　　者：熊超[1] 金迪[1] 刘娜[1] 杨昌友[1] 刘文华[2] 郑小旋[1] 段丽平[1] 杨森焙[1] 张静[1] 

机构地区：[1]华中科技大学同济医学院公共卫生学院儿少卫生与妇幼保健学系,湖北武汉430030 [2]华中科技大学同济医学院公共卫生学院流行病与卫生统计学系,武汉430030

出　　处：《中国妇幼卫生杂志》2011年第5期205-209,共5页Chinese Journal of Women and Children Health

摘　　要：目的探讨孕产期及新生儿期危险因素与儿童孤独症的关系,为孤独症的早期预防提供科学依据。方法利用Stata统计软件对2000-2011年间国内外孤独症影响因素的病例对照研究进行meta分析。通过异质性检验后计算合并的优势比(OR)及其95%置信区间(CI),再评估发表偏倚和进行敏感性分析。结果共检索到相关文献344篇,最终12篇文献被纳入meta分析。包括病例组2887例,对照组8716例。孕产期及新生儿期各危险因素的合并OR值及95%CI为:新生儿黄疸3.77(1.86,7.64)、新生儿缺氧或窒息3.57(2.56,4.98)、母孕期阴道出血3.17(2.19,4.59)、低出生体重2.40(1.98,2.92)、早产2.16(1.56,2.98)、母孕期疾病史3.05(1.60,5.83)、剖宫产1.57(1.36,1.82)、母孕期服药史1.66(1.09,2.51)、过期产1.77(1.10,2.85)。结论孤独症的发生可能与新生儿黄疸、新生儿缺氧或窒息、母孕期阴道出血、低出生体重、早产、母孕期疾病史和剖宫产有关,但仍需要进一步研究证实。Objective To provide a Meta-analysis of the association among pregnancy-related or neonatus-related factors and risk of autism for early interventions.Methods We searched in CBMdisc and PubMed databases for studies aimed at examining the linkage of risk factors between prenatal,perinatal or neonatal period and autism in the past twelve years.Using Stata 11.0 to test the heterogeneous,calculate the odds ratios and 95% confidence intervals,access the publication bias and take on sensitivity analyses.Results 12 were finally included in meta-analysis from 344 literatures.Including 2887 cases and 8716 controls,respectively.The OR values and 95%CI of risk factors associated with autism were：jaundice[OR=3.77,95%CI（1.86,7.64）],anoxia or asphyxia of newborn[OR=3.57,95%CI（2.56,4.98）],vaginal bleeding[OR=3.17,95%CI（2.19,4.59）],children in low birth weight[OR=2.40,95%CI（1.98,2.92）],preterm children[OR=2.16,95%CI（1.56,2.98）],maternal gestational disease [OR=3.05,95%CI（1.60,5.83）] and caesarean section[OR=1.57,95%CI（1.36,1.82）],maternal gestational medication use[OR=1.66,95%CI（1.09,2.51）],post-term pregnancy[OR= 1.77,95%CI（1.10,2.85）].Conclusions Although we have positive results that neonatal jaundice,anoxia or asphyxia of newborn,vaginal bleeding,children in low birth weight,preterm children,maternal gestational disease and caesarean section are relevance with autism,it is too arbitrary to make a conclusion that these risk factors are the causes of autism,for some bias or methodological problems may exist and further studies are needed to confirm the possibilities.

关 键 词：孤独症 危险因素 META分析 

分 类 号：R749.94[医药卫生—神经病学与精神病学]