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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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https://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn2096-5087.2025.02.016      或      https://www.zjyfyxzz.com/CN/Y2025/V37/I2/181
[1] 贾美香. 2021年度儿童发展障碍康复行业蓝皮书[M].北京:北京大学医学出版社,2022.
JIA M X.Blue book on the child developmental disorder rehabilitation industry,2021[M].Beijing:Peking University Medical Press,2022.(in Chinese)
[2] 赵亚楠,罗雅楠,王翔宇,等.中国2~6岁孤独症儿童家庭直接经济负担研究[J].中华疾病控制杂志,2021,25(9):1085-1090.
ZHAO Y N,LUO Y N,WANG X Y,et al.Research on the direct financial burden on families with 2-6 years old children having autism spectrum disorder in China[J].Chin J Dis Control Prev,2021,25(9):1085-1090.(in Chinese)
[3] HIROTA T,KING B H.Autism spectrum disorder:a review[J].JAMA,2023,329(2):157-168.
[4] 梁晓菲,李秀萍,胡韦菊,等.孤独症谱系障碍危险因素调查分析[J].国际精神病学杂志,2024,51(3):841-847.
LIANG X F,LI X P,HU W J,et al.Analysis of risk factors for autism spectrum disorder[J].J Int Psychiatry,2024,51(3):841-847.(in Chinese)
[5] JIANG Y,GUO C H,KUANG M,et al.Examining associations of folic acid supplements administered to mothers during pre-conceptional and prenatal periods with autism spectrum disorders in their offspring:insights from a multi-center study in China[J/OL].Front Public Health,2024,12[2024-10-02].https://doi.org/10.3389/fpubh.2024.1321046.
[6] JIA J Y,NAN Y Z,YU X L,et al.Prenatal,perinatal and parental risk factors for autism spectrum disorder in China:a case-control study[J/OL].BMC Psychiatry,2024,24[2024-10-02].https://doi.org/10.1186/s12888-024-05643-0.
[7] 彭娟. 孤独症谱系障碍儿童出生后疾病相关危险因素研究[D].长沙:中南大学,2023.
PENG J.The study for developing risk factors of children with autism spectrum disorders[D].Changsha:Central South University,2023.(in Chinese)
[8] 范政军. 阜阳地区孤独症谱系障碍患儿初诊临床特征及相关危险因素分析[D].合肥:安徽医科大学,2023.
FAN Z J.Clinical characteristics and risk factors of children with autism spectrum disorder at first diagnosis in Fuyang area[D].Hefei:Anhui Medical University,2023.(in Chinese)
[9] 刘金桢. 孤独症谱系障碍患儿孕期危险因素的病例对照研究[D].衡阳:南华大学,2023.
LIU J Z.Analysis of environmental risk factors during pregnancy in children with autism spectrum disorder[D].Hengyang:University of South China,2023.(in Chinese)
[10] 刘贤,郭程,伊鹏,等.孕前及孕期母亲被动吸烟与儿童孤独症谱系障碍的关联分析[J].中国儿童保健杂志,2022,30(4):371-375.
LIU X,GUO C,YI P,et al.Association between maternal passive smoking exposure before during pregnancy and the risk of autism spectrum disorders in offspring[J].Chin J Child Health Care,2022,30(4):371-375.(in Chinese)
[11] 邵娜,赵梅,魏晓蝶,等.合肥市孤独症儿童生命早期影响因素的病例对照研究[J].中国儿童保健杂志,2022,30(2):194-198.
SHAO N,ZHAO M,WEI X D,et al.Case control study on the risk factors of autistic children during early life in Hefei[J].Chin J Child Health Care,2022,30(2):194-198.(in Chinese)
[12] 占红. 孤独症与屏幕暴露的相关性分析[D].十堰:湖北医药学院,2021.
ZHAN H.Correlation between autism and screen exposure[D].Shiyan:Hubei University of Medicine,2021.(in Chinese)
[13] 邢玉. 孤独症谱系障碍与母亲孕期增重、孕前BMI的关联性研究[J].实用临床医学,2021,22(5):26-30.
XING Y.Association of autism spectrum disorder with maternal gestational weight gain and prepregnant body mass index[J].Pract Clin Med,2021,22(5):26-30.(in Chinese)
[14] 张沛延. ASD儿童危险因素暴露与NLGN4X基因的交互作用研究[D].唐山:华北理工大学,2021.
ZHANG P Y.Study on the interaction between exposure to risk factors and NLGN4X gene in children with ASD[D].Tangshan:North China University of Science and Technology,2021.(in Chinese)
[15] 黄小玲,张玉琼,唐玉文,等.学龄前孤独症谱系障碍儿童相关危险因素的调查分析[J].神经损伤与功能重建,2021,16(4):213-215.
HUANG X L,ZHANG Y Q,TANG Y W,et al.Investigation and analysis of relevant risk factors for autism spectrum disorder in preschool children[J].Neural Injury Funct Reconstruct,2021,16(4):213-215.(in Chinese)
[16] 刁颖颖,岳保珠,张同清,等.儿童孤独症谱系障碍影响因素及与维生素D的关系分析[J].中国听力语言康复科学杂志,2021,19(2):156-160.
DIAO Y Y,YUE B Z,ZHANG T Q,et al.Analysis of related influencing factors of autism spectrum disorder in children[J].Chin Sci J Hear Speech Rehabilitat,2021,19(2):156-160.(in Chinese)
[17] 范雅利. 孤独症谱系障碍患儿母亲孕期及围产期危险因素的病例对照研究[D].新乡:新乡医学院,2021.
FAN Y L.A case-control study of maternal risk factors during pregnancy and perinatal period in children affected by autism spectrum disorder[D].Xinxiang:Xinxiang Medical College,2021.(in Chinese)
[18] 张羽珊. 生命早期铅、镉暴露与孤独症谱系障碍的关联研究及诺模图的构建与验证[D].乌鲁木齐:新疆医科大学,2021.
ZHANG Y S.Relationship of lead and cadmium exposure in early childhood with autism spectrum disorders and construction and validation of nomogram[D].Urumqi:Xinjiang Medical University,2021.(in Chinese)
[19] HUANG S J,WANG X,SUN T,et al.Association of breastfeeding for the first six months of life and autism spectrum disorders:a national multi-center study in China[J].Nutrients,2021,14(1):45-55.
[20] 颜海. 孕前及孕期高危因素与儿童孤独症的相关性研究[D].大连:大连医科大学,2020.
YAN H.The correlation between high-risk factors pre-pregnancy and during pregnancy and autism in children[D].Dalian:Dalian Medical University,2020.(in Chinese)
[21] 吴昊. 儿童孤独症谱系障碍遗传易感性和母亲孕产期因素及其交互作用研究[D].武汉:华中科技大学,2020.
WU H.Research on genetic susceptibility,prenatal and perinatal factors,and gene-environment interaction to autism spectrum disorder[D].Wuhan:Huazhong University of Science and Technology,2020.(in Chinese)
[22] ZHANG A Y,LI J J,ZHANG Y W,et al.Epilepsy and autism spectrum disorder:an epidemiological study in Shanghai,China[J/OL].Front Psychiatry,2019,10[2024-10-02].https://doi.org/10.3389/fpsyt.2019.00658.
[23] 李准,杨少萍,汤珺,等.围孕期相关因素与儿童孤独症关系的分析[J].中国儿童保健杂志,2018,26(7):717-720.
LI Z,YANG S P,TANG J,et al.Study on the association between peripregnancy factors and childhood autism[J].Chin J Child Health Care,2018,26(7):717-720.(in Chinese)
[24] LI L,LI M,LU J P,et al.Prenatal progestin exposure is associated with autism spectrum disorders[J/OL].Front Psychiatry,2018,9[2024-10-02].https://doi.org/10.3389/fpsyt.2018.00611.
[25] 吉洋. 锦州市孤独症儿童发病影响因素的病例对照研究[D].锦州:锦州医科大学,2016.
JI Y.Case-control study on influencing factors of pathogenesis of autism children in Jinzhou city[D].Jinzhou:Jinzhou Medical University,2016.(in Chinese)
[26] 田金来,王丽英,张向葵.公立小学儿童孤独症谱系障碍患病率及其影响因素[J].中国临床心理学杂志,2016,24(2):277-281,292.
TIAN J L,WANG L Y,ZHANG X K.Prevalence and influencing factors of autism spectrum disorders in public primary school[J].Chin J Clin Psychol,2016,24(2):277-281,292.(in Chinese)
[27] 刘栋,张淑云,邹时朴,等.孤独症谱系障碍相关危险因素的Logistic回归分析[J].中华实用儿科临床杂志,2016,31(2):143-145.
LIU D,ZHANG S Y,ZOU S P,et al.Logistic regression analysis on risk factors of autism spectrum disorders[J].Chin J Appl Clin Pediatr,2016,31(2):143-145.(in Chinese)
[28] 刘丹. 儿童孤独症谱系障碍的环境危险因素研究[D].杭州:浙江大学,2016.
LIU D.Environmental risk factors for autism spectrum disorders in children[D].Hangzhou:Zhejiang University,2016.(in Chinese)
[29] 郑冬梅,吕莹,孙彩虹,等.母孕产期环境因素与孤独症谱系障碍的关联研究[J].哈尔滨医科大学学报,2015,49(6):524-527.
ZHENG D M,LYU Y,SUN C H,et al.Relationship between prenatal and pregnancy environmental factors and autism spectrum disorder[J].J Harbin Med Univ,2015,49(6):524-527.(in Chinese)
[30] 李侠,凌子羽,王建敏,等.儿童孤独症围孕期危险因素的1∶1配对病例对照研究[J].华中科技大学学报(医学版),2015,44(3):357-361.
LI X,LING Z Y,WANG J M,et al.Periconceptional risk factors for childhood autism:a 1∶1 matched case-control study[J].Acta Med Univ Sci Technol Huazhong,2015,44(3):357-361.(in Chinese)
[31] 马居飞. 孤独症谱系障碍患儿临床特点及发病影响因素分析[D].青岛:青岛大学,2015.
MA J F.The clinical features and etiology factors for children with autism spectrum disorders[D].Qingdao:Qingdao University,2015.(in Chinese)
[32] 马居飞,匡桂芳,衡中玉,等.孤独症谱系障碍病因影响因素分析[J].中国儿童保健杂志,2015,23(6):647-650.
MA J F,KUANG G F,HENG Z Y,et al.Study on factors of childhood autism spectrum disorder[J].Chin J Child Health Care,2015,23(6):647-650.(in Chinese)
[33] 高磊. 孤独症谱系障碍儿童的早期危险因素及早期征兆研究[D].天津:天津医科大学,2015.
GAO L.The study of early risk factors and early manifestation of autism spectrum disorder[D].Tianjin:Tianjin Medical University,2015.(in Chinese)
[34] 郑艳,沈妙文.儿童孤独症与母亲怀孕前后相关影响因素的调查研究[J].中国妇幼保健,2014,29(28):4609-4610.
ZHENG Y,SHEN M W.Investigation on the factors affecting autism in children before and after mother's pregnancy[J].Matern Child Health Care China,2014,29(28):4609-4610.(in Chinese)
[35] 沈屹东. 孕产期危险因素及PGR基因多态性与退化型孤独症关系的研究[D].长沙:中南大学,2014.
SHEN Y D.Study about prenatal,perinatal risk factors and PGR polymorphisms in Chinese Han autistic children with developmental regression[D].Changsha:Central South University,2014.(in Chinese)
[36] 邓琪玮. 衡阳市学龄前儿童孤独症谱系障碍患病率及相关因素研究[D].衡阳:南华大学,2014.
DENG Q W.The research of prevalence and correlative factors of autism disorders among preschool children in Hengyang[D].Hengyang:University of South China,2014.(in Chinese)
[37] 冼丹霞,金宇,谢笑英,等.儿童孤独症发病危险因素的病例对照研究[J].中国儿童保健杂志,2014,22(1):24-27.
XIAN D X,JIN Y,XIE X Y,et al.Case-control study on risk factors of childhood autism[J].Chin J Child Health Care,2014,22(1):24-27.(in Chinese)
[38] 苏媛嫒,张欣,李爱月,等.天津市婴幼儿孤独症患病率与危险因素[J].中国妇幼保健,2011,26(32):5004-5007.
SU Y A,ZHANG X,LI A Y,et al.Prevalence and risk factors of infantile autism in Tianjin[J].Matern Child Health Care China,2011,26(32):5004-5007.(in Chinese)
[39] 张娜. 学龄前儿童孤独症早期筛查工具比较及危险因素研究[D].长沙:中南大学,2010.
ZHANG N.A study on the comparison of early screening instruments and risk factors of preschool children autism[D].Changsha:Central South University,2010.(in Chinese)
[40] 冯淑瑜,朱明芬,张继永,等.孤独症危险因素的病例对照研究[J].中国行为医学科学,2004,13(2):56-57.
FENG S Y,ZHU M F,ZHANG J Y,et al.Case-control study on risk factors of childhood autism[J].Chin J Behav Med Brain Sci,2004,13(2):56-57.(in Chinese)
[41] 李素水,杨晓玲,贾美香.孤独症患者围产期危险因素的研究[J].中华精神科杂志,1998,31(3):50-52.
LI S S,YANG X L,JIA M X.A study of perinatal risk factors in patients with autism[J].Chin J Psychiatry,1998,31(3):50-52.(in Chinese)
[42] VAN'T HOF M,ESTER W A,VAN BERCKELAER-ONNES I,et al.Do early-life eating habits predict later autistic traits? Results from a population-based study[J/OL].Appetite,2021,156[2024-10-02].https://doi.org/10.1016/j.appet.2020.104976.
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