Association between guardian's first notice of autism symptom of children and time to seek medical care / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the symptoms of autism of children that caused the first notice of guardian, related risk factors and the influence on the time to seek medical care.</p><p><b>METHODS</b>The children with autism aged <5 years were selected from autism rehabilitation centers in Wuhan, Changsha, Haikou, Liuzhou and Changsha between September 2012 and April 2014, and their guardians were retrospectively surveyed by using questionnaire. SPSS 13.0 software was used for statistical analysis.</p><p><b>RESULTS</b>A total of 415 children with autism were included in the study. Including 355 boys (85.54%) and 60 girls (14.46%), the sex ratio was 5.9 : 1. The most common concern of guardian were: language dysplasia (20.72%); ignoring of people or lack of interaction with others (18.55%); repeat and weird action pattern (14.94%). The age when the first symptom occurred, which causing guardians' concern, ranged from 8 months to 28 months, the time when guardian began to concern varied with symptom (χ² =46.64, P<0.000 1). Guardian's educational level, guardian's contact time with the children, guardian's intimate degree with the children, the age of guardian, family type and tie had no statistical association with the fist autism symptom that caused guardian's concern. The age of the children at first medical care seeking ranged from 10.5 months to 33 months, the time of the first medical care seeking varied with symptom (χ² =46.10, P<0.000 1). Up to 90.74% of the guardians delayed the medical care seeking of the children with autism, but the symptom specific differences in medical care delay had no statistical significance (χ² =9.46, P=0.579 6).</p><p><b>CONCLUSION</b>The symptom of the children with autism causing guardian's first notice were mainly verbal communication barrier, social interaction barrier and restricted interests and behaviors. Guardian's educational level and intimate degree with children had no correlation with the symptom which caused guardian's first notice. The time when guardian began to concern and the time for children's medical care varied with guardian's first notice.</p>

Association between mothers' body mass index before pregnancy or weight gain during pregnancy and autism in children / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the relationship between mothers' body mass index (BMI) before pregnancy or weight gain during pregnancy and autism in children.</p><p><b>METHODS</b>From 2013 to 2014, the 181 children with autism and 181 healthy children matched by sex and age from same area were included in this study. According to mothers' BMI before pregnancy, the selected cases were divided into 3 groups: low, normal and high group. Then 3 groups were divided into 3 subgroups based on mother' s weight gain during pregnancy: low, normal and high group, according to the recommendations of Institute of Medicine. Logistic regression analysis and χ(2) test were conducted with SPSS 18.0 software to analysis the relationship between mothers' BMI before pregnancy or weight gain during pregnancy and autism in children.</p><p><b>RESULTS</b>The age and sex distributions of case group and control group were consistent (χ(2)=0.434, P>0.05). The mothers' BMI before pregnancy of case group was higher than that of control group (χ(2)=9.580, P<0.05) ,which was (21.28±3.80) kg/m(2) for case group and (19.87±2.83) kg/m(2) for control group. The proportion of cases in high BMI group (10.5%) was much higher than that in control group (2.8%) . The risk of children with autism in high BMI group was 3.7 times higher than that in normal BMI group (OR=3.71, 95% CI: 1.34-10.24). In normal BMI group, the proportion of mothers who had excessive weight gain during pregnancy was higher in case group (44.1%) than in control group (33.9%). In high BMI group, the proportion of mothers who had excessive weight gain was higher in case group (52.6%) than in control group (20.0%) . In normal BMI group (χ(2) =8.690, P<0.05) and high BMI group (χ(2)=4.775, P<0.05), the weight gain during pregnancy was associated with autism in children. Logistic regression analysis showed that mothers' BMI before pregnancy (unadjusted OR=1.89, 95% CI: 1.26-2.85, adjusted OR=1.52, 95% CI: 1.19-2.27) and weight gain during pregnancy were the risk factors for autism in children (unadjusted OR=1.63, 95% CI: 1.08-1.25, adjusted OR=1.64, 95% CI: 1.21-2.21).</p><p><b>CONCLUSION</b>Overweight or obesity before pregnancy and excessive weight gain during pregnancy were associated with autism in children, suggesting that women who plan to be pregnant should pay attention to body weight control.</p>

Survey on overweight and obesity of preschool children in rural areas from ten provinces of China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To analyze the status of overweight and obesity among preschool children in rural areas of ten provinces in China.</p><p><b>METHODS</b>Using data from "Physical development of rural children under the age of 7 from ten provinces of China in 2006", preschool children were selected as the object of study. Overweight, mild obesity, moderately obese, severe obesity were defined as:weight was over 10%, 20%, 30%, 50% than the same sex under height population reference mean. SPSS 13.0 software was used for statistical analysis. χ² test was used to compare rates.</p><p><b>RESULTS</b>A total number of 38 923 preschool children were included in the study. The overall prevalence of overweight was 4.18%, with boy's higher than girl's (χ² = 4.343 6, P = 0.037 1) and the highest rate of overweight (5.80%) was seen in the 3-year-old group. The overall prevalence of obesity was 1.21% , with majority as mild (0.78%). There was no significant difference between boys and girls (χ² = 0.389 0, P = 0.532 8). The 6 to 7 year old group had the highest rate of obesity (1.42%). In the ten provinces, the prevalence rates of overweight were 1.38%-7.62% and the obesity were 0.57%-3.08% . The prevalence rates of overweight and obesity showed the highest in Jilin and lowest in Guangxi.</p><p><b>CONCLUSION</b>The overall prevalence rates of overweight and obesity among preschool children in rural areas of China were low, with 3 to 4-year-olds appeared in the age of high incidence of overweight and obesity. The overall prevalence rates of overweight and obesity in northern area were higher than in other areas.</p>

1:2 matched case-control study on the risk factors related to congenital heart disease during the peri-conceptional period / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the possible risk factors during the periconceptional period relevant on the occurrence of congenital heart diseases (CHD) in the offspring.</p><p><b>METHODS</b>A 1:2 matched case-control study was designed. From January 2012 to January 2014 in a district from Wuhan city, HuBei province, children were proved by MCH institutions through the "free screening for congenital heart disease" program. Cases with CHD were screened out by conventional auscultation, echocardiography figure and confirmed by physicians from the high-level hospitals. According to age, gender, community paired healthy children were chosen as controls. EpiData 3.1 software was used to input data, using SPSS 11.5 software to analyze the possible risk factors under simple and multiple factors logistic regression.</p><p><b>RESULTS</b>Information from parents of 138 cases and 276 controls was collected. 27 major factors from the conditional logistic regression analysis showed that factors as:mental stress during early pregnancy, calcium supplement in the early stage of pregnancy, pregnancy malnutrition, having histories of abnormal childbearing, women with multiparous experiences and residence nearby sources of pollution (enterprises) etc. were associated with the incidence of congenital heart disease in the offspring. Data from the multivariate logistic regression analysis showed that factors as:mental stress during early pregnancy (HR = 3.35, 95%CI: 1.28-8.79), pregnancy malnutrition during pregnancy (HR = 1.50, 95% CI:1.10-2.03) and with abnormal childbearing history (HR = 1.62, 95% CI:1.03-2.57) were risk factors. However, calcium supplement during early pregnancy (HR = 0.40, 95% CI:0.25-0.65) could reduce the risk of CHD.</p><p><b>CONCLUSION</b>The occurrence of CHD might be related to factors as:mental stress during early pregnancy, calcium supplement during early pregnancy, pregnancy malnutrition and having histories of abnormal childbearing. Peri-conceptional care should be strengthened to reduce the incidence of congenital heart disease.</p>