Incidence of Autism Spectrum Disorder and Global Developmental Delay in Infants With Brachial Plexus Birth Injury: An Early Association With Birth Asphyxia.
Thomas J McQuillan, Daniel Gabriel, Patricia E Miller, Peter M Waters, Andrea S Bauer
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引用次数: 0
Abstract
Background: Autism spectrum disorder (ASD) and global developmental delay (GDD) are 2 common central nervous system (CNS) diagnoses in children. We hypothesized that the incidence of ASD and GDD is higher among patients with brachial plexus birth injury (BPBI), and that the subgroup of patients with BPBI and CNS diagnoses would have increased rates of maternal risk factors and birth-related complications.
Methods: A single institution prospective cohort of 849 patients with BPBI was used. Demographics, perinatal history, maternal factors and treatment, and patient outcomes were recorded. Charts were reviewed for concomitant diagnoses of GDD and ASD. Cohorts were compared regarding demographics and treatment data, and then age and sex-matched to analyze for risk factors.
Results: Of 834 unique patients seen for BPBI, 772 met inclusion criteria. Seventeen subjects had a diagnosis of GDD (13) or ASD (4) before the age of 5 years, an incidence of 2.2%, which is not different from the general population incidence of ASD and GDD. After age and sex-matching, a history of birth asphyxia (58% vs. 15%, P <0.05) was most associated with an increased likelihood of ASD or GDD diagnosis. Rates of shoulder dystocia and eventual surgical management did not differ between cohorts.
Conclusions: Birth complications, especially birth asphyxia, are associated with GDD/ASD in patients with BPBI. Providers should consider that BPBI and GDD/ASD may coexist in children with a history of a complicated birth.
背景:自闭症谱系障碍(ASD)和全面发育迟缓(GDD)是儿童两种常见的中枢神经系统(CNS)诊断。我们假设臂丛出生损伤(BPBI)患者的ASD和GDD发生率更高,并且BPBI和CNS诊断的患者亚组可能增加母体危险因素和出生相关并发症的发生率。方法:采用单机构前瞻性队列研究,纳入849例BPBI患者。记录人口统计学、围产期史、产妇因素和治疗以及患者结局。复习GDD和ASD合并诊断的图表。对队列进行人口统计和治疗数据的比较,然后对年龄和性别进行匹配,以分析风险因素。结果:在834例独特的BPBI患者中,772例符合纳入标准。17例受试者在5岁前被诊断为GDD(13例)或ASD(4例),发生率为2.2%,与一般人群ASD和GDD的发病率无差异。在年龄和性别匹配后,出生窒息史(58% vs. 15%)。结论:出生并发症,尤其是出生窒息,与BPBI患者的GDD/ASD相关。提供者应考虑有复杂分娩史的儿童可能同时存在BPBI和GDD/ASD。证据等级:四级。
期刊介绍:
Journal of Pediatric Orthopaedics is a leading journal that focuses specifically on traumatic injuries to give you hands-on on coverage of a fast-growing field. You''ll get articles that cover everything from the nature of injury to the effects of new drug therapies; everything from recommendations for more effective surgical approaches to the latest laboratory findings.