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首页> 外文期刊>Annals of epidemiology >Have Secular Changes in Perinatal Risk Factors Contributed to the Recent Autism Prevalence Increase? Development and Application of a Mathematical Assessment Model
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Have Secular Changes in Perinatal Risk Factors Contributed to the Recent Autism Prevalence Increase? Development and Application of a Mathematical Assessment Model

机译：围产期危险因素的长期变化是否导致近期自闭症患病率增加？数学评估模型的开发与应用

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Background: A 57% increase in the U.S. prevalence of autism spectrum disorders (ASD) for 8-year-old children born in 1994 versus 1998 was recently reported. Methods: To quantify the possible contributions of given risk/predictive factors on the recent ASD prevalence increase, we formulated a mathematical model based on the baseline risk factor prevalence (RFP), the proportionate change in RFP (cRFP), and the magnitude of the association between the risk factor and ASD [estimated relative risk (RR)]. We applied this model to several pregnancy-related factors (preterm, very preterm, low and very low birth weight, multiple birth, cesarean delivery, breech presentation, and assisted reproductive technology use). RFP and cRFP estimates for each factor were obtained from U.S. population-based surveillance datasets. Estimated RRs were obtained from a series of systematic literature reviews. Results: We estimate that each risk factor examined, alone or in various combinations, accounted for a very small proportion (<1%) of the ASD increase. Additionally, hypothetical scenarios indicate RFP, cRFP, and RR all need to be sizable for a risk factor to appreciably influence ASD prevalence. Conclusions: Thus, although various pregnancy factors have been found to be associated with ASDs, the contribution of many of these factors to the recently observed ASD increase is likely minimal.
机译：背景：最近报告称，1994年出生的8岁儿童与1998年相比，美国自闭症谱系障碍（ASD）患病率增加了57％。方法：为了量化特定风险/预测因素对近期ASD患病率增加的可能贡献，我们基于基线风险因素患病率（RFP），RFP的比例变化（cRFP）和风险因素与ASD之间的关联[估计相对风险（RR）]。我们将此模型应用于与妊娠相关的几个因素（早产，非常早产，出生体重偏低和极低，多胎，剖宫产，臀位表现以及辅助生殖技术的使用）。每个因素的RFP和cRFP估算值是从美国基于人口的监视数据集中获得的。 RR估计值来自一系列系统的文献综述。结果：我们估计，单独或以各种组合方式检查的每种危险因素在ASD升高中所占的比例很小（<1％）。此外，假设情况表明，RFP，cRFP和RR都需要适当调整，以使风险因素明显影响ASD患病率。结论：因此，尽管已发现各种妊娠因素与ASD相关，但是许多这些因素对最近观察到的ASD升高的贡献可能很小。

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