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预防医学  2025, Vol. 37 Issue (2): 181-188    DOI: 10.19485/j.cnki.issn2096-5087.2025.02.016
  妇幼保健 本期目录 | 过刊浏览 | 高级检索 |
中国儿童孤独症谱系障碍影响因素的Meta分析
陈溪, 杨泓生, 李炜, 翟睿, 姜妍琳, 王俊宏
北京中医药大学东直门医院儿科,北京 100700
Influencing factors for autism spectrum disorder in Chinese children: a meta analysis
CHEN Xi, YANG Hongsheng, LI Wei, ZHAI Rui, JIANG Yanlin, WANG Junhong
Department of Pediatrics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
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摘要 目的 系统评价中国儿童孤独症谱系障碍(ASD)的影响因素,为ASD风险预测和干预提供循证依据。方法 检索中国知网、万方数据知识服务平台、维普中文科技期刊数据库、PubMed和Embase等数据库,收集建库至2024年8月关于中国儿童ASD影响因素的研究文献。采用R 4.4.1软件进行Meta分析;逐一剔除文献进行敏感性分析;采用Egger回归检验评价发表偏倚。结果 初期获得文献9 015篇,最终纳入文献38篇,均为高质量文献,包括样本149 607人,其中ASD患病5 974例。Meta分析结果显示,相关疾病家族史(OR=14.958)、产妇年龄≥35岁(OR=2.287)和父母有害职业史(OR=3.511)等人口学因素,流产史(OR=5.832)、孕产前未补充叶酸(OR=4.566)、孕产前烟草暴露(OR=2.596)、孕产前其他不良接触史(OR=3.533)、孕期感染性疾病史(OR=3.753)、孕期非感染性疾病史(OR=2.563)、孕期精神心理问题(OR=3.864)、孕期用药史(OR=6.651)、孕期不良环境(OR=3.754)、严重妊娠反应(OR=5.082)、产期异常(OR=2.987)、剖宫产(OR=1.659)、围产期其他不利因素(OR=3.856)、新生儿窒息史(OR=2.792)和新生儿黄疸(OR=3.687)等妊娠因素,非纯母乳喂养(OR=2.510)、过早/过多屏幕暴露(OR=3.589)和饮食喂养问题(OR=3.113)等养育因素,以及男性(OR=3.333)和惊厥/癫痫病史(OR=7.035)等个体因素是中国儿童ASD的影响因素。结论 中国儿童ASD患病主要与相关疾病家族史、流产史、孕产前未补充叶酸、孕期用药史、过早/过多屏幕暴露和惊厥/癫痫病史等23个影响因素有关。
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陈溪
杨泓生
李炜
翟睿
姜妍琳
王俊宏
关键词 孤独症谱系障碍影响因素儿童Meta分析    
AbstractObjective To systematically evaluate the influencing factors for autism spectrum disorder (ASD) in Chinese children, so as to provide the evidence for risk prediction and intervention of ASD. Methods The publications pertaining to the influencing factors for ASD in Chinese children were retrieved from CNKI, Wanfang Data, VIP, PubMed and Embase database from inception to August 2024. A meta-analysis was performed using R package version 4.4.1. Sensitivity analysis was performed using the "leave-one-out" evaluation procedure. Publication bias was assessed using Egger regression test. Results A total of 38 high-quality articles out of 9 015 articles were finally included, covering 149 607 individuals, with 5 974 cases of ASD. The meta-analysis showed that demographic factors including family history of related diseases (OR=14.958), maternal age of ≥35 years (OR=2.287) and parental history of hazardous occupations (OR=3.511); pregnancy-related factors including history of abortion (OR=5.832), no folate supplementation before and during pregnancy (OR=4.566), tobacco exposure before and during pregnancy (OR=2.596), history of other adverse exposures before and during pregnancy (OR=3.533), history of infectious diseases during pregnancy (OR=3.753), history of non-infectious diseases during pregnancy (OR=2.563), psychological problems during pregnancy (OR=3.864), history of medication during pregnancy (OR=6.651), adverse environmental exposures during pregnancy (OR=3.754), severe pregnancy reactions (OR=5.082), abnormal perinatal period (OR=2.987), cesarean delivery (OR=1.659), other perinatal adverse factors (OR=3.856), history of neonatal asphyxia (OR=2.792) and neonatal jaundice (OR=3.687); parenting factors including non-exclusive breastfeeding (OR=2.510), early/excessive screen exposure (OR=3.589) and feeding problems (OR=3.113); and individual factors including being male (OR=3.333) and history of convulsions/epilepsy (OR=7.035) were influencing factors for ASD in Chinese children. Conclusion The prevalence of ASD in Chinese children is primarily associated with 23 influencing factors, including family history of related diseases, history of abortion, no folate supplementation before and during pregnancy, medication during pregnancy, early/excessive screen exposure and history of convulsions/epilepsy.
Key wordsautism spectrum disorder    influencing factor    child    meta-analysis
收稿日期: 2024-09-12      修回日期: 2024-10-02      出版日期: 2025-02-10
中图分类号:  R749.94  
基金资助:北京中医药大学双一流学科建设项目(90010951310112); 北京中医药大学王俊宏教学名师工作坊建设项目(MSGZF-201818)
作者简介: 陈溪,博士研究生在读,中医儿科学专业
通信作者: 王俊宏,E-mail:drjhwang@bucm.edu.cn   
引用本文:   
陈溪, 杨泓生, 李炜, 翟睿, 姜妍琳, 王俊宏. 中国儿童孤独症谱系障碍影响因素的Meta分析[J]. 预防医学, 2025, 37(2): 181-188.
CHEN Xi, YANG Hongsheng, LI Wei, ZHAI Rui, JIANG Yanlin, WANG Junhong. Influencing factors for autism spectrum disorder in Chinese children: a meta analysis. Preventive Medicine, 2025, 37(2): 181-188.
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http://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn2096-5087.2025.02.016      或      http://www.zjyfyxzz.com/CN/Y2025/V37/I2/181
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