Abstract: Objective To explore the peri-pregnancy risk factors for childhood autism,in order to provide evidence for prevention and intervention. Methods A 1∶3 matched case-control study was used in this research.A total of 180 autistic children in two medical institutions of Wuhan were selected as case group from 2013 to 2015,and 540 healthy children in Wuhan were recruited as control group.Caregivers or parents were investigated by using self-designed Childhood Psychological and Behavioral Development and Related Factors Questionnaire.Epidata 3.1 software was used for data-entry.Statistical analysis was conducted via SPSS 24.0 software. Results Factors that may increase risk for childhood autism included maternal stress during pregnancy (OR=20.118,95%CI: 9.812~60.696),postterm pregnancy (OR=7.379,95%CI: 1.328~40.985),pregnancy diseases (OR=2.876,95%CI: 1.528~5.414),pre-pregnancy overweight/obesity (OR=2.309,95%CI: 1.184~4.501),history of adverse pregnancy outcomes (OR=1.678,95%CI: 1.056~2.665),neonatal asphyxia (OR=4.624,95%CI: 1.416~15.105),paternal age≥30 (OR=2.712,95%CI: 1.711~4.299),paternal education of junior college/undergraduate/+(OR=6.511,95%CI: 3.878~10.931). Conclusion Several peri-pregnancy factors are associated with childhood autism,positive peri-pregnancy care may reduce these factors and subsequently decrease the risk of autism.

Key words: childhood autism, peri-pregnancy, risk factors

摘要： 目的 探究围孕期相关因素与儿童孤独症的关系,为孤独症的防治提供依据。方法 选取2013-2015年武汉市两所医疗卫生机构中确诊的180例武汉市孤独症患儿,采用1∶3配对病例对照研究方法,选择与病例匹配的540例武汉市健康儿童。采用自行设计的《儿童心理行为发育及相关因素调查表》对儿童的主要监护人进行问卷调查。使用Epidata 3.1软件录入数据,利用SPSS 24.0软件对数据进行统计分析。结果 儿童孤独症与母亲孕期精神压力(OR=20.118,95%CI:9.812~60.696)、过期妊娠(OR=7.379,95%CI:1.328~40.985)、孕期患病(OR=2.876,95%CI:1.528~5.414)、孕前超重/肥胖(OR=2.309,95%CI:1.184~4.501)、不良孕产史(OR=1.678,95%CI:1.056~2.665)、新生儿窒息/缺氧(OR=4.624,95%CI:1.416~15.105)、父亲生育年龄≥30岁(OR=2.712,95%CI:1.711~4.299),父亲大专/本科及以上学历(OR=6.511,95%CI:3.878~10.931)有关。结论 围孕期的多种因素在儿童孤独症的发生发展中起到一定作用,积极做好围孕期保健,减少这些因素的发生有助于降低孤独症风险。

关键词: 儿童孤独症, 围孕期, 危险因素