出生体质量、胎龄与孤独症儿童大运动发育的相关性  

Correlations between gestational age, birth weight and motor development in children with autism

作　　者：盘舒娅 李准 杨森焙 张静[1] Pan Shuya;Li Zhun;Yang Senbei;Zhang Jing(Department of Maternal Child Healthcare,School of Public Health,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

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,武汉430030

出　　处：《中华行为医学与脑科学杂志》2019年第8期678-683,共6页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：国家自然科学基金项目(81273084).

摘　　要：目的探索孤独症儿童大运动发育情况及胎龄、出生体质量对其的影响.方法采用1∶1配对病例对照研究方法分别选取2012年至2014年间国内多家医疗保健机构收治的396例5岁以下孤独症患儿及同性别、居住地且年龄相差不超过3个月的健康儿童,运用自拟的《儿童心理行为发育及相关因素调查表》对主要监护人进行回顾性调查,利用EpiData3.1软件建立数据库,运用SAS9.4软件进行统计分析.结果共调查5岁以下儿童396对,其中男童342对(86.3%),女童54对(13.7%),男女性别比为6.33∶1;病例组年龄为(39.44±11.99)月,对照组为(39.96±12.24)月.病例组与对照组在出生体质量(χ2=3.888,P=0.140)及胎龄别体质量(χ2=0.462,P=0.794)等特征方面差异无统计学意义,胎龄构成比差异有统计学意义(χ2=9.476,P=0.009).与同龄正常儿童相比,孤独症儿童在抬头、翻身及独坐等8项大运动上存在较为明显的发育延迟;早产影响孤独症儿童抬头[3.50(1.00)月]、翻身[6.00(3.50)月]及独坐[8.00(2.50)月]的发生时间,是抬头延迟发生的危险因素(OR=2.911,95%CI=1.491~5.681);小于胎龄儿(smallforgestationalage,SGA)也是独立行走发生时间延迟的危险因素(OR=1.703,95%CI=1.053~2.754).结论孤独症患儿存在大运动发育延迟现象,早产、SGA均为延迟发生的危险因素,早期发现大运动发育异常有助于家长及儿童保健工作人员提高警惕,协助孤独症的早期诊断.Objective To explore the motor development and how it is influenced by gestational age and birth weight in children with autism, and provide evidence for the applications of motor development in the early diagnosis of autism. Methods A 1∶1 matched case-control study was conducted between 2012 and 2014.A total of 396 children under 5 years old with autism were enrolled in this study, their counterparts were healthy children 3 month younger/ older and with the same gender and residence.Guardians of participants were investigated using self-designed childhood psychological and behavioral development and related factors questionnaire.EpiData 3.0 software was used to establish the data base and SAS 9.4 software was used for data analysis. Results 396 pairs were enrolled in this study which including 342 pairs of boys(86.3%) and 54 pairs of girls(13.7%), the gender ratio was 6.33∶1;The average month age of case group was (39.44±11.99) months and (39.96±12.24) months for the control group.There was no significant difference observed in the distribution of birth weight(χ2=3.888, P=0.140) and gestational age specific birth weight(χ2=0.462, P=0.794)between two groups.But the distribution of gestational age was significantly different(χ2=9.476, P=0.009).Children with autism have significant delaying in motor development compared with healthy children at same age, which including head lifting(3.50(1.00)month), rolling(6.00(3.50)month), sitting(8.00(2.50)month), etc.Preterm birth could have an effect on head lifting, rolling and sitting in children with autism, and also was the risk factor of delaying occurrence of head lifting(OR=2.911, 95%CI=1.491-5.681);Small for gestational age(SGA) was also a risk factor of delaying in walking(OR=1.703, 95%CI=1.053-2.754). Conclusion Evident delaying of motor development is observed among children with autism.Both preterm and SGA are risk factors for delayed motor development.Thus, early recognization of abnormities in motor development should raise awareness among caregivers an

关 键 词：孤独症 早产 出生体质量 胎龄别体质量 

分 类 号：R749.94[医药卫生—神经病学与精神病学]