OBJECTIVES: To explore the association between maternal gestational diabetes mellitus (GDM) exposure and the development of autism spectrum disorder (ASD) in offspring. METHODS: A case-control study was conducted, recruiting 221 children with ASD and 400 healthy children as controls. Questionnaires and interviews were used to collect information on general characteristics of the children, socio-economic characteristics of the family, maternal pregnancy history, and maternal disease exposure during pregnancy. Multivariate logistic regression analysis was used to investigate the association between maternal GDM exposure and the development of ASD in offspring. The potential interaction between offspring gender and maternal GDM exposure on the development of ASD in offspring was explored. RESULTS: The proportion of maternal GDM was significantly higher in the ASD group compared to the control group (16.3% vs 9.4%, P=0.014). After adjusting for variables such as gender, gestational age, mode of delivery, parity, and maternal education level, maternal GDM exposure was a risk factor for ASD in offspring (OR=2.18, 95%CI: 1.04-4.54, P=0.038). On the basis of adjusting the above variables, after further adjusting the variables including prenatal intake of multivitamins, folic acid intake in the first three months of pregnancy, and assisted reproduction the result trend did not change, but no statistical significance was observed (OR=1.94, 95%CI: 0.74-5.11, P=0.183). There was an interaction between maternal GDM exposure and offspring gender on the development of ASD in offspring (P<0.001). Gender stratified analysis showed that only in male offspring of mothers with GDM, the risk of ASD was significantly increased (OR=3.67, 95%CI: 1.16-11.65, P=0.027). CONCLUSIONS Maternal GDM exposure might increase the risk of ASD in offspring. There is an interaction between GDM exposure and offspring gender in the development of ASD in offspring.
Child ; Female ; Pregnancy ; Humans ; Male ; Diabetes, Gestational/etiology* ; Autism Spectrum Disorder/etiology* ; Case-Control Studies ; Gestational Age ; Mothers

Anxiety ; etiology ; prevention & control ; Autism Spectrum Disorder ; complications ; therapy ; Caregivers ; psychology ; Child ; Coronavirus Infections ; complications ; Humans ; Pandemics ; Pneumonia, Viral ; complications ; Stress, Psychological ; prevention & control

The Autism Spectrum Rating Scale (ASRS) and the Social Responsiveness Scale (SRS) have been widely used for screening autism spectrum disorder (ASD) in the general population during epidemiological studies, but studies of individuals with intellectual disability (ID) are quite limited. Therefore, we recruited the parents/caregivers of 204 ASD cases, 71 ID cases aged 6-18 years from special education schools, and 402 typically developing (TD) children in the same age span from a community-based population to complete the ASRS and SRS. The results showed that the ID group scored significantly lower on total and subscale scores than the ASD group on both scales (P < 0.05) but higher than TD children (P < 0.05). Receiver operating characteristic analyses demonstrated a similar fair performance in discriminating ASD from ID with the ASRS (area under the curve (AUC) = 0.709, sensitivity = 77.0%, specificity = 52.1%, positive predictive value (PPV) = 82.2%) and the SRS (AUC = 0.742, sensitivity = 59.8%, specificity = 77.5%, PPV = 88.4%). The results showed that individuals with ID had clear autistic traits and discriminating ASD from ID cases was quite challenging, while assessment tools such as ASRS and SRS, help to some degree.
Adolescent ; Age Distribution ; Age Factors ; Autism Spectrum Disorder ; complications ; psychology ; Child ; China ; Female ; Humans ; Intellectual Disability ; etiology ; Male ; Psychiatric Status Rating Scales ; Psychometrics ; Retrospective Studies ; Social Behavior ; Statistics, Nonparametric

OBJECTIVETo study the association between overweight/obesity in parents before maternal pregnancy and the development of autism spectrum disorders (ASD) in offspring.

METHODSA total of 36 children who were diagnosed with ASD (ASD group) and 72 normal children matched for sex and age (control group) were enrolled. A questionnaire survey was performed to collect the general information, including body height and body weight of parents before maternal pregnancy and maternal weight gain during pregnancy. Univariate and multivariate logistic regression analyses were used to investigate the association between overweight/obesity in parents before maternal pregnancy and ASD in offspring.

RESULTSThe ASD group had a significantly higher detection rate of overweight/obesity in the father than the control group (56% vs 32%; P=0.018) before maternal pregnancy. The univariate and multivariate logistic regression analyses showed that overweight/obesity of the father before maternal pregnancy was a risk factor for ASD in offspring (OR=2.66 and 2.58 respectively; P<0.05).

CONCLUSIONSOverweight/obesity of the father before maternal pregnancy is an independent risk factor for ASD in offspring, and therefore, it is important for the father to control his body mass index within the normal range before maternal pregnancy.

Autism Spectrum Disorder ; etiology ; Body Mass Index ; Child, Preschool ; Female ; Humans ; Infant ; Logistic Models ; Male ; Obesity ; complications ; Overweight ; complications ; Parents ; Risk Factors

OBJECTIVETo examine the association between autism spectrum disorder (ASD) and epilepsy in children.

METHODSA total of 190 children with ASD were enrolled. A self-designed questionnaire, Childhood Autism Rating Scale, and Autism Behavior Checklist were used to determine the association between ASD and epilepsy.

RESULTSAmong the 190 children with ASD, 20 (10.5%) had epileptic seizures and 12 (6.3%) were diagnosed with epilepsy. The rates of abnormal physical development and hearing disorders before the age of one year were significantly higher in ASD children with epileptic seizures than in those without epileptic seizures (P<0.05). The ASD children diagnosed with epilepsy and those receiving epilepsy treatment had a significantly increased rate of abnormal physical development before the age of one year (P<0.05). The ASD children with epileptic seizures had poorer sensory responses and behavioral competencies than those without epileptic seizures (P<0.05). Epilepsy treatment have a positive effect on behavioral competencies in ASD children (P<0.05).

CONCLUSIONSThere is a significant association between ASD and epilepsy in children. The possibility of the comorbidity between ASD and epilepsy may be assessed according to the status of growth and development before the age of one year, sensory responses and behavioral competencies, and the presence or absence of epileptic seizures.

Adolescent ; Autism Spectrum Disorder ; complications ; Child ; Child, Preschool ; Developmental Disabilities ; etiology ; Epilepsy ; complications ; Female ; Hearing Disorders ; etiology ; Humans ; Male

OBJECTIVETo quantitatively and comprehensively investigate the association between maternal folate supplementation during pregnancy and the risk of autism spectrum disorder (ASD) in the offspring.

METHODSPubMed, Embase, Scopus, Cochrane Library, EBSCO, CNKI, Wanfang Data, VIP Database, and Chinese Biomedical Database were searched to collect the articles on maternal folate supplementation during pregnancy and the risk of ASD in children. Odds ratio (OR) and 95% confidence interval (CI) were used to determine the effect size. Stata 12.0 software was used for the Meta analysis. Publication bias evaluation and sensitivity analysis were also performed.

RESULTSA total of 10 articles were included according to the inclusion and exclusion criteria, including 15 studies which involved 4 459 cases and 1 225 835 controls. The Meta analysis showed that maternal folate supplementation during pregnancy significantly reduced the risk of ASD in the offspring in the total population (OR=0.798, 95%CI: 0.669-0.952, P=0.012). The subgroup analysis revealed that maternal folate supplementation during pregnancy was associated with a reduced risk of ASD in the offspring in both the Asian population (OR=0.664, 95%CI: 0.428-1.032, P=0.069) and the Western population (OR=0.817, 95%CI: 0.671-0.996, P=0.045).

CONCLUSIONSMaternal folate supplementation during pregnancy may reduce the risk of ASD in the offspring, especially in the Western population.

Autism Spectrum Disorder ; etiology ; Dietary Supplements ; Female ; Folic Acid ; administration & dosage ; Humans ; Pregnancy ; Risk

OBJECTIVETo analyze the clinical manifestations and gene mutation of a 6 year old boy with autism spectrum disorders (ASD).

METHODSPeripheral blood of the boy and his parents were subjected to genetic testing.

RESULTSThe patient was diagnosed with typical autism. Exome sequencing has identified mutations of four candidate genes, namely TUT1, DIAPH3, REELIN and SETD2, which were confirmed with Sanger sequencing. Analysis of family members confirmed that the missense mutations of DIAPH3 and SETD2 genes were of de novo origin.

CONCLUSIONMissense mutations of DIAPH3 and SETD2 genes may have contributed to the risk of ASD. Disrupted neurogenesis associated with such mutations may have been the underlying mechanism for ASD.

Adaptor Proteins, Signal Transducing ; chemistry ; genetics ; Amino Acid Sequence ; Autism Spectrum Disorder ; etiology ; genetics ; Child ; Humans ; Male ; Molecular Sequence Data ; Mutation

OBJECTIVEThis study aimed to explore the association between periconceptional fish consumption by parents and autism spectrum disorder (ASD) and intelligence deficiency (ID).

METHODSA case-control study was conducted through a questionnaire with 108 ASD cases, 79 ID cases, and 108 controls. The ASD and ID cases were students from special educational schools in Tianjin from 2012 to 2014. The age- and sex-matched controls were from a high school, three primary schools, and a kindergarten in Tianjin. Multivariate logistic regression was performed.

RESULTSPaternal habit of eating hairtail before fertilization, maternal preference for fruits during pregnancy, and maternal habit of eating grass carp during pregnancy were preventive factors for ASD. Paternal habit of drinking alcohol before fertilization was a risk factor for ID, whereas maternal preference for fruits during pregnancy and maternal habit of eating crucian carp during pregnancy were protective factors for ID.

CONCLUSIONParental fish consumption is beneficial for the prevention of ASD and ID. Meanwhile, the protective effects of fish consumption on ASD and ID differ. More attention should be paid to the combined effect of other food when eating fish.

Adolescent ; Animals ; Autism Spectrum Disorder ; epidemiology ; etiology ; Case-Control Studies ; Child ; Child, Preschool ; China ; epidemiology ; Diet ; adverse effects ; Environmental Exposure ; Female ; Fishes ; Humans ; Incidence ; Intellectual Disability ; epidemiology ; etiology ; Male ; Maternal Exposure ; Paternal Exposure ; Pregnancy ; Prenatal Exposure Delayed Effects ; epidemiology ; etiology ; Risk Factors ; Species Specificity

OBJECTIVETo investigate the environmental risk factors for autism spectrum disorders (ASD) in children.

METHODSIn this case-control study, 81 boys with ASD, 74 boys with global developmental delay (GDD), and 163 healthy boys were enrolled. A self-designed nurturing environment questionnaire was used to record general demographic data, family social-economic status, parents' living habits and environmental exposure, maternal health status during pregnancy, birth situations, and rearing environment after birth. Multivariate logistic regression was used to identify environmental risk factors for ASD and GDD.

RESULTSMultivariate logistic regression analysis showed that six environmental risk factors such as maternal occupational toxicant exposure, diseases during pregnancy and a history of passive smoking, children's birth places, the frequency of outdoor activities in the second year after birth, and the opportunities to communicate with other age-matched children were significantly associated with the incidence of ASD (OR=20.67, 3.559, 2.422, 2.646, 23.820, and 5.081, respectively; P<0.05). Among the above six risk factors, passive smoking during pregnancy, the opportunities to communicate with their peers, and the frequency of outdoor activities in the second year after birth were also significantly associated with the incidence of GDD (P<0.05).

CONCLUSIONSMaternal occupational toxicant exposure, diseases during pregnancy, and low level of children's birth places may be the specific risk factors associated with ASD, and passive smoking during pregnancy, fewer opportunities to communicate with their peers, and fewer outdoor activities in the second year after birth are non-specific risk factors for ASD, indicating that the development of ASD may be influenced by both genes and environmental factors.

Autism Spectrum Disorder ; etiology ; Case-Control Studies ; Child, Preschool ; Developmental Disabilities ; etiology ; Female ; Humans ; Logistic Models ; Male ; Maternal Exposure ; Pregnancy ; Risk Factors ; Tobacco Smoke Pollution ; adverse effects

Autism spectrum disorders (ASD) are a group of developmental dysfuntion of nervous system characterized by social interaction and communication disorders, restricted interests and repetitive stereotyped behaviors. The incidence of ASD has been increasing through the world. Some studies have shown that early reasonable individualized comprehensive intervention can obviously improve the prognosis of children with ASD. The etiology of ASD is unclear now, and behavioral and developmental intervention is the main therapy for ASD. The reasonable application of some drugs can improve the efficacy of the behavioral intervention for concomitant symptoms in ASD. With the in-depth study of the pathogenesis of ASD, bumetanide, oxytocin, vitamin D and hyperbaric oxygen therapy have been found to be promising for the improvement of core symptoms of ASD. This article reviews the research advances in the behavioral and developmental intervention and drug therapy for ASD.
Autism Spectrum Disorder ; etiology ; psychology ; therapy ; Behavior Therapy ; Child ; Humans ; Hyperbaric Oxygenation ; Interpersonal Relations ; Vitamin D ; therapeutic use