A Case-control Study Of Maternal Risk Factors During Pregnancy And Perinatal Period In Children Affected By Autism Spectrum Disorder

BackgroundIn recent years,with the growing numbers of children with autism spectrum disorders,scholars around the world have been the case for the further research and continuously made new progress.A growing number of studies have shown that genetic factors,environmental factors and biological factors closely related to the patients with ASD,but the pathogenesis of ASD is not substantive research.Relevant studies have shown that ASD is not caused by a single factor,but by the interaction of multiple factors.The combination of genetic and environmental factors has become a research hotpot.PurposeTo investigate the correlation between the mother’s lifestyle and environmental factors during pregnancy and the onset of ASD,understand the effects of pregnancy mood,sleep,living environment and other factors on ASD,provides the basis for early prevention and further investigation of ASD in children.MethodsUsing the case control study method,109 cases of autism diagnosed at Henan Children’s Hospital were selected as the case group,frequency matching of age and gender,select 122 children with non-mental disorders who were treated at the same hospital during the same period as a control group,using self-designed questionnaire on factors related to maternal and child health during pregnancy and perinatal period in Henan Province.Epidemiological investigation training was conducted before the investigation,and on-site investigations were conducted by investigators on the mothers of children in the case and control groups.The questionnaire refers to domestic and foreign literature and related books,includes the general situation of the child,the general situation of the parents,the situation of the mother during pregnancy and the perinatal period.Using SPSS22.0 to describe the results of the questionnaire statistically,Chi-square test was used for comparison between groups,multivariate Logistic regression analysis was used for risk factors analysis,odds ratio(OR)and 95% confidence intervals(95%CI)were calculated.Results1.Comparison of basic social demography characteristics between case and control group: a total of 231 children were included in this study,including 109 cases in the case group and 122 cases in the control group.The case group was equitably comparable to the control group,and there was no statistically significant difference in age and gender.The differences of the father’s education background,the mother’s BMI and IVF between the case group and the control group were statistically significant(P<0.05).There was no significant difference in parental age between the case group and the control group.2.Comparison of birth and feeding patterns of children in case and control group:low birth weight,feeding pattern,newborns with abnormal skin color,neonatal complications,neonatal jaundice,neonatal respiratory distress syndrome between the case group and the control group were statistically significant(P<0.05),there were no significant differences in preterm delivery,cesarean delivery and parental age(P>0.05).According to the results of single logistic regression analysis,low birth weight(OR=4.347,95%CI:1.385～13.642),mixed breastfeeding(OR=2.433,95%CI:1.326～4.463),artificial feeding(OR=3.545,95%CI:1.567～8.018),neonatal jaundice(OR=2.528,95%CI:1.410～4.532),complications(OR=2.798,95%CI:1.602～4.887),newborns with abnormal skin color(OR=9.584,95%CI:1.179～77.920),are the risk factor of ASD.3.Comparison of maternal factors related to pregnancy period between case and control group: among pregnancy-related factors,prenatal complications,drug use,mental stimulation,poor sleep quality,irregular sleep,negative emotions,accommodation affected by noise and decoration materials had statistical significance between the case group and the control group(P<0.05).Pregnancy complications(OR=8.442,95%CI:3.573～19.94),drug use(OR=7.423,95%CI:1.622～33.961),mental stimulation(OR=9.584,95%CI:1.179～77.920),poor quality of sleep(OR=1.888,95%CI:1.118～3.187),irregular sleep(OR=2.122,95%CI:1.224～3.679),negative emotions(OR=6.977,95%CI:3.901～12.480),accommodation affected by noise(OR=4.768,95%CI:2.146～10.595),and decorate materials(OR=3.085,95%CI:1.152～8.262)are risk factors of ASD.4.Comparison of maternal factors related to perinatal period between case and control group: among perinatal related factors,there were statistically significant differences in poor sleep quality,irregular sleep,bad mood,and address affected by noise and decoration materials between the case group and the control group(P<0.05).poor quality of sleep(OR=2.758,95%CI:1.558～4.884),irregular sleep(OR=4.623,95%CI:2.646～8.075),negative emotions(OR=9.967,95%CI:5.287～18.790),accommodation affected by noise(OR=6.964,95%CI:2.561～18.936)and decorate materials(OR=3.448,95%CI:1.199～9.918)are risk factors for ASD.5.Multivariate logistic regression analysis between pregnancy and perinatal:according to the results of multiple logistic regression analysis,complications during pregnancy(OR=9.918)were most closely associated with the occurrence of ASD,while perinatal bad mood(OR=5.646)and residence affected by noise(OR=6.900)were more closely associated with the occurrence of ASD.ConclusionLow birth weight,feeding pattern,newborns with abnormal skin color,neonatal complications,neonatal jaundice,education level of parents,neonatal respiratory distress syndrome,mother’s body mass index,IVT,pregnancy complications,drug use,mental stimulation.During pregnancy and perinatal period,poor sleep quality,irregular sleep patterns,bad mood,Accommodation affected by noise and decoration materials are associated with the incidence of ASD.There was no correlation between preterm delivery,cesarean delivery,parental age and the incidence of ASD.Pregnancy complications were most closely associated with the occurrence of ASD.