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孙艳丽, 江澜, 王晓燕, 曹慧, 李晴, 严双琴, 陶芳标. 婴儿期社会性反应评估对18月龄孤独症行为预测作用队列研究[J]. 中国公共卫生, 2016, 32(11): 1463-1466. DOI: 10.11847/zgggws2016-32-11-04
引用本文: 孙艳丽, 江澜, 王晓燕, 曹慧, 李晴, 严双琴, 陶芳标. 婴儿期社会性反应评估对18月龄孤独症行为预测作用队列研究[J]. 中国公共卫生, 2016, 32(11): 1463-1466. DOI: 10.11847/zgggws2016-32-11-04
SUN Yan-li, JIANG Lan, WANG Xiao-yan.et al, . Sociality performance in early infancy as predictors of autism spectrum disorders among 18 month infants: a cohort study[J]. Chinese Journal of Public Health, 2016, 32(11): 1463-1466. DOI: 10.11847/zgggws2016-32-11-04
Citation: SUN Yan-li, JIANG Lan, WANG Xiao-yan.et al, . Sociality performance in early infancy as predictors of autism spectrum disorders among 18 month infants: a cohort study[J]. Chinese Journal of Public Health, 2016, 32(11): 1463-1466. DOI: 10.11847/zgggws2016-32-11-04

婴儿期社会性反应评估对18月龄孤独症行为预测作用队列研究

Sociality performance in early infancy as predictors of autism spectrum disorders among 18 month infants: a cohort study

  • 摘要: 目的 识别孤独症在婴幼儿早期的行为发育特点,为早期干预赢得时机。方法 采用前瞻性队列研究的方法建立队列,记录各阶段研究对象的生长发育状况,分阶段填写适当的《婴儿社会性反应问卷》并计算得分,在儿童18个月龄时,用《CHAT-23问卷》进行孤独症行为的筛查,计算3、6、9、12个月龄儿童社会性反应得分,并根据百分位数P25P75将其划分为低分组、中分组及高分组,采用χ2方法分析18个月龄儿童的孤独症行为在各月龄不同分组中的分布情况,利用二元logistic回归模型分析12月龄内婴儿的社会性反应与18月龄孤独症行为的关联效应。结果 本研究共纳入3月龄(3个月±7 d)的婴儿1 207人,截止到18月龄,追踪到队列儿童共1 085人,筛查出孤独症行为儿童99人,检出率9.1%; 3、6、9、12月龄的低分组孤独症行为检出率依次为16.1%、13.3%、13.7%和14.5%;单因素分析结果显示,各月龄社会性反应得分中低分组的孤独症行为检出率均高于高分组,且各月龄差异均有统计学意义(P<0.05);二元logistic回归分析显示,低分组是发生孤独症谱系障碍(ASDs)的危险因素,3、6、9和12月龄的RR值(95%CI)分别为2.94(1.50~5.75)、3.28(1.32~8.09)、2.38(1.16~4.88)和4.90(2.08~11.49)。结论 虽然孤独症行为的机制目前尚不明确,但是在儿童12月龄内某些特定行为对ASDs具有预测作用,可为早期干预提供依据。

     

    Abstract: Objective To explore the relationship between infant sociality performance at the ages of 3-12 months and the occurrence of autism spectrum disorders (ASDs) at the age of 18 months.Methods Totally 1 207 infants aged 3 months(±7 days)at the enrollment were recruited at Maanshan Municipal Instruction Center for Community Health Service for a prospective cohort study from March through October 2012.Infant Sociality Performance Questionnaire (ISPQ) was applied to assess sociality performance of the infants at the ages of 3,6,9,and 12 months;the ISPQ scores of the infants at different ages were calculated and then the infants were assigned into the low- (1-25 percentile),medium-(26-75 percentile),and high-(76-100 percentile)score groups according their ISPQ scores.Checklist for Autism in Toddlers (CHAT-23) was adopted to screen ASDs among the infants at the age of 18 months.Chi-square analysis and binary logistic regression analysis were performed in data analyses.Results Of all infants enrolled,1 085 were followed up to their 18 months of age and 99 were identified as suspected ASDs,with an overall detection rate of 9.1%.Among the infants with low ISPQ scores at the ages of 3,6,9,and 12 months,the detection rates of ASDs were 16.1%,13.3%,13.7%,and 14.5%,respectively.The results of Chi-square analysis showed that compared to the infants with high ISPQ score,those with low ISPQ score had a higher prevalence of ASDs.Binary logistic regression analyses showed that the low ISPQ score was a risk factors for ASDs in early childhood,with the relative risk (RR) and its 95%confidence interval (95%CI) of 2.94 (1.50-5.75),3.28 (1.32-8.09),2.38 (1.16-4.88),and 4.90 (2.08-11.49) for the infants at the ages of 3,6,9,and 12 months,respectively.Conclusion The results suggest that early sociality performance may be a predictor of incident of ASDs and may provide evidences for early diagnosis and treatment of the disease.

     

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