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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 explore the relationship between maternal and neonatal risk factors and autistic children and provide a scientific basis for the early prevention of autism. Methods Stata statistical software was used to do a meta-analysis on the case-control study on the influencing factors of autism both in China and abroad during 2000-2011. The combined odds ratio (OR) and its 95% confidence interval (CI) were calculated after the heterogeneity test, and post publication bias and sensitivity analysis were reassessed. Results A total of 344 related articles were retrieved and the final 12 articles were included in the meta-analysis. Including the 2887 cases of cases, the control group of 8716 cases. The combined OR and 95% CI of risk factors during pregnancy and neonatal period were neonatal jaundice 3.77 (1.86,7.64), neonatal hypoxia or asphyxia 3.57 (2.56,4.98), pregnancy-induced vaginal bleeding 3.17 (2.19 , 4.59), low birth weight 2.40 (1.98, 2.92), premature birth 2.16 (1.56, 2.98), maternal pregnancy history 3.05 (1.60,5.83), cesarean section 1.57 (1.36,1.82) , 2.51), expired 1.77 (1.10,2.85). Conclusions The incidence of autism may be related to neonatal jaundice, neonatal hypoxia or asphyxia, vaginal bleeding during pregnancy, low birth weight, premature birth, maternal pregnancy history and cesarean section, but further studies are needed to confirm.