文章摘要
邵珊珊,黄锟,严双琴,尤优,潘维君,陈星,曹慧,朱鹏,郝加虎,陶芳标.孕中晚期妊娠相关焦虑与幼儿18月龄孤独症样行为的队列研究[J].中华流行病学杂志,2018,39(6):826-829
孕中晚期妊娠相关焦虑与幼儿18月龄孤独症样行为的队列研究
Association between pregnancy-related anxiety of pregnant women and autism-like behavior in their offspring at 18 months of age
收稿日期:2017-09-28  出版日期:2018-06-20
DOI:10.3760/cma.j.issn.0254-6450.2018.06.025
中文关键词: 妊娠相关焦虑  孤独症样行为  带养人  队列研究
英文关键词: Pregnancy-related anxiety  Autism-like behavior  Fosterer  Cohort study
基金项目:国家重点研发计划(2016YFC1000204-2)
作者单位E-mail
邵珊珊 230032 合肥, 安徽医科大学公共卫生学院儿少卫生与妇幼保健学系 人口健康与优生安徽省重点实验室  
黄锟 230032 合肥, 安徽医科大学公共卫生学院儿少卫生与妇幼保健学系 人口健康与优生安徽省重点实验室  
严双琴 243000 安徽省马鞍山市妇幼保健院  
尤优 230032 合肥, 安徽医科大学公共卫生学院儿少卫生与妇幼保健学系 人口健康与优生安徽省重点实验室  
潘维君 243000 安徽省马鞍山市妇幼保健院  
陈星 230032 合肥, 安徽医科大学公共卫生学院儿少卫生与妇幼保健学系 人口健康与优生安徽省重点实验室  
曹慧 243000 安徽省马鞍山市妇幼保健院  
朱鹏 230032 合肥, 安徽医科大学公共卫生学院儿少卫生与妇幼保健学系 人口健康与优生安徽省重点实验室  
郝加虎 230032 合肥, 安徽医科大学公共卫生学院儿少卫生与妇幼保健学系 人口健康与优生安徽省重点实验室  
陶芳标 230032 合肥, 安徽医科大学公共卫生学院儿少卫生与妇幼保健学系 人口健康与优生安徽省重点实验室 fbtao@126.com 
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中文摘要:
      目的 探讨孕中晚期妊娠相关焦虑与其子女18月龄时孤独症样行为的关系。方法 应用前瞻性队列研究设计,分别在孕中期、孕晚期采用《妊娠相关焦虑量表》评定孕妇妊娠相关焦虑症状,在儿童18月龄时运用《婴幼儿孤独症筛查表-23》A部分评定幼儿孤独症样行为。使用多项logistic回归法分析孕期妊娠相关焦虑对幼儿孤独症样行为的影响。结果 控制协变量后,与无孤独症样行为组相比,孕中晚期均有妊娠相关焦虑者子女比2个孕期均无妊娠相关焦虑者子女更容易发生较多孤独症样行为(RR=2.43,95%CI:1.21~4.86)。但按主要带养人是否为幼儿母亲进行分层后发现,仅在主要带养人为母亲情况下,孕中晚期均有妊娠相关焦虑组子女18月龄时发生较多孤独症样行为的风险,显著高于孕中晚期均无妊娠相关焦虑组(RR=4.22,95%CI:1.73~10.32),在主要带养人不是母亲情况下并不显著。结论 孕中晚期妊娠相关焦虑与幼儿孤独症样行为的关系并不强劲,受儿童带养人情况的影响。
英文摘要:
      Objective To investigate the relationship of pregnancy-related anxiety of pregnant women in second/third trimesters and autism-like behaviors in their offspring at 18 months of age.Methods Based on a prospective cohort study design, we evaluated the situation of pregnancy-related anxiety of women during second and third trimesters through a Pregnancy-Related Anxiety Questionnaire. Subjects under study were classified into three groups, 1) those with pregnancy-related anxiety during both trimesters, 2) those with pregnancy-related anxiety at one trimester and 3) those without pregnancy-related anxiety in either trimester. When their children were 18 months, autism-like behaviors (ALB) were evaluated, using the part A of Checklist for Autism in Toddlers-23, and then classified into three groups as non-ALB group, minor ALB group and major ALB group. Multi-nominal logistic Regression was used to analyze the relationship of pregnancy-related anxiety with autism-like behaviors.Results Compared with non-ALB group, children whose mother with pregnancy-related anxiety during both trimesters presented significant higher risk on ALB than children whose mother without pregnancy-related anxiety in these two periods (relative risk, RR=2.43, 95% CI:1.21-4.86, P=0.012), major factors as pregnant women's IQ and gestational diabetes mellitus, premature delivery and education levels of fosterers on these pregnant women were under control. Our results from the stratified analysis showed:when in the subgroup that mother was the main fosterer of the child, there was an significant increase of risk in children whose mothers with pregnancy-related anxiety during both trimesters (RR=4.22, 95% CI:1.73-10.32, P=0.002).Conclusion The association between pregnancy-related anxiety and autism-like behavior was not strong but influenced by the fosterer of the child.
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