Correlations between gestational age,birth weight and motor development in children with autism / 中华行为医学与脑科学杂志

Objective To explore the motor development and how it is influenced by gestational age and birth weight in children with autism,and provide evidence for the applications of motor development in the early diagnosis of autism. Methods A 1 ∶ 1 matched case-control study was conducted between 2012 and 2014. A total of 396 children under 5 years old with autism were enrolled in this study,their counterparts were healthy children 3 month younger/ older and with the same gender and residence. Guardians of partici-pants were investigated using self-designed childhood psychological and behavioral development and related factors questionnaire. EpiData 3. 0 software was used to establish the data base and SAS 9. 4 software was used for data analysis. Results 396 pairs were enrolled in this study which including 342 pairs of boys (86. 3%) and 54 pairs of girls(13. 7%),the gender ratio was 6. 33 ∶ 1; The average month age of case group was (39. 44±11. 99) months and (39. 96±12. 24) months for the control group. There was no signifi-cant difference observed in the distribution of birth weight(χ2=3. 888,P=0. 140) and gestational age specif-ic birth weight(χ2=0. 462,P=0. 794)between two groups. But the distribution of gestational age was signifi-cantly different(χ2=9. 476,P=0. 009) . Children with autism have significant delaying in motor develop-ment compared with healthy children at same age,which including head lifting(3. 50(1. 00) month),rolling (6. 00(3. 50)month),sitting(8. 00(2. 50)month),etc. Preterm birth could have an effect on head lifting, rolling and sitting in children with autism,and also was the risk factor of delaying occurrence of head lifting (OR=2. 911,95%CI=1. 491-5. 681);Small for gestational age( SGA) was also a risk factor of delaying in walking(OR=1. 703,95%CI=1. 053-2. 754). Conclusion Evident delaying of motor development is ob-served among children with autism. Both preterm and SGA are risk factors for delayed motor development. Thus,early recognization of abnormities in motor development should raise awareness among caregivers and children care workers and assist in early diagnosis of children with autism.

Relationship between domestic violence and posttraumatic stress disorder among women living in the communities of Wuhan city / 中华流行病学杂志

Objective To understand the prevalence of domestic violence and the correlation between domestic violence and posttraumatic stress disorder (PTSD) so as to improve the mental health status of women in Wuhan city of China.Methods A cross-sectional study was conducted in the community health service center in Wuhan.Participants were women who came to the center for gynecological examination.Data on general condition,social support,injury,epidemiological characteristics of domestic violence and PTSD were gathered.Chi-square,student-t and CochranArmitage trend tests were employed to compare the distribution of each characteristic variable between PTSD and non-PTSD group.Binary logistic regression was used to analyze the correlation between domestic violence and PTSD.Results A total of 1 015 women were effectively surveyed.The life-time incidence rates of events related to domestic,psychological,physical and sexual violence were 29.36％,28.28％,6.60％ and 3.55％,respectively.The overall prevalence rate of PTSD was 4.73％.Women who suffered from domestic violence had higher risk of PTSD (OR=2.11,95％ CI:1.04-4.29) than those who never experiencing domestic violence.Women who suffered from psychological or physical violence were 5.06 times more likely to suffer from PTSD (OR=5.06,95％CI:1.91-13.42).Conclusion A strong correlation between domestic violence and PTSD was seen.Victims who suffered from domestic violence should be provided with psychological counseling to reduce the risk of PTSD.

Relationship between domestic violence and posttraumatic stress disorder among women living in the communities of Wuhan city / 中华流行病学杂志

Objective To understand the prevalence of domestic violence and the correlation between domestic violence and posttraumatic stress disorder (PTSD) so as to improve the mental health status of women in Wuhan city of China.Methods A cross-sectional study was conducted in the community health service center in Wuhan.Participants were women who came to the center for gynecological examination.Data on general condition,social support,injury,epidemiological characteristics of domestic violence and PTSD were gathered.Chi-square,student-t and CochranArmitage trend tests were employed to compare the distribution of each characteristic variable between PTSD and non-PTSD group.Binary logistic regression was used to analyze the correlation between domestic violence and PTSD.Results A total of 1 015 women were effectively surveyed.The life-time incidence rates of events related to domestic,psychological,physical and sexual violence were 29.36％,28.28％,6.60％ and 3.55％,respectively.The overall prevalence rate of PTSD was 4.73％.Women who suffered from domestic violence had higher risk of PTSD (OR=2.11,95％ CI:1.04-4.29) than those who never experiencing domestic violence.Women who suffered from psychological or physical violence were 5.06 times more likely to suffer from PTSD (OR=5.06,95％CI:1.91-13.42).Conclusion A strong correlation between domestic violence and PTSD was seen.Victims who suffered from domestic violence should be provided with psychological counseling to reduce the risk of PTSD.

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>

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>

Prenatal factors associated with high BMI status of infants and toddlers / 中华儿科杂志

<p><b>OBJECTIVE</b>To explore prenatal related factors of high BMI status in children at 1 and 2 years of age.</p><p><b>METHOD</b>A total of 2 220 newborns from Shenyang, Wuhan and Guangzhou were recruited in this birth cohort, thereafter they were followed up to two years of age.Self-administered questionnaires were used to collect such variables as social-demographic characteristics and feeding practice, etc. The anthropometric measures of children were collected by trained health staff. The data were subjected to multiple logistic regression analysis to determine the related factors for high BMI among infants and toddlers.</p><p><b>RESULT</b>The number of children with high BMI status were 550 (32.80%) at one year of age and 309 (26.23%) at two, respectively. The number of boys with high BMI status were 178 and girls 309 at age two years. The prevalence of high BMI status among boys (29.1%) at age two was significantly higher than that of girls (23.1%) (χ² = 5.52, P = 0.02). Logistic regression analysis showed that after the adjustment for sex, parental educational level, family economic status and other confounding factors, maternal passive smoking during pregnancy [OR:aged one:1.38 (1.05-1.82);aged two:1.48 (1.05-2.09)], maternal pre-pregnancy overweight and obesity [aged one:1.29 (1.05-1.58); aged two:1.35 (1.04-1.76)], paternal overweight and obesity [aged one:1.50 (1.21-1.87); aged two:1.47 (1.11-1.95)] and birth weight [aged one:1.53 (1.05-1.82); aged two:1.87 (1.33-2.63)]were identified to be associated with high BMI status in children.</p><p><b>CONCLUSION</b>Maternal passive smoking during pregnancy, paternal and maternal (pre-pregnancy) overweight or obesity and high birth weight are found to be important related factors for high BMI status in young children. Childhood overweight/obesity prevention should be considered starting as early as before pregnancy.</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>

Study on the psychological-health status and its relationship with social capital among left-behind children in rural area, Macheng, Hubei province / 中华流行病学杂志

Objective To understand the status of mental health among left-behind children in rural area and to explore its relationship with social capital.Methods A sample of 1 031 leftbehind children,aged 10-18 years,was randomly selected from six schools of two townships in Macheng city of Hubei province where large number of rural parents were working in the urban area.Data from a cross-sectional survey was collected among the sampled students from primary,middle and high schools,using self-designed questionnaires which targeting the ‘ left-behind’ condition and social capital Mental Health Inventory of Middle-School Students (MMHI-60).Chi-square test was used to compare the differences in mental health among different groups.Spearman correlation and logistical regression analysis were applied to assess the relationship between social capital and mental health.Results The prevalence of mental problems was 54.12％.Results from linear x2 test indicated that the detection rates of mental problems were parallel with the monthly pocket money and the reduction in the frequency of contacting migrant father/mother (P＜0.01).Results from the multiple logistic regression analysis indicated that students who were senior (OR=2.410-2.682,P＜0.001),and who reported not caring about their parents (OR =2.048-2.420,P＜ 0.001) were at increased risks for mental health problems.After controlling the demographic characteristics and conditions of staying relevant factors,family social capital (OR =0.845,95％ CI:0.801-0.891),neighborhood social capital (OR=0.867,95％CI:0.826-0.910) and school social capital (OR=0.893,95％CI:0.863-0.923) were all associated with declined risks of mental health problems,in which the family social capital was the most important one.Conclusion The prevalence of mental health problems was high among the left-behind children in rural area.Much attention should be paid to assist these children in improving their mental health status.One promising approach appeared to be improving social capitals which would include family social capital,neighborhood social capital,and school social capital to assist these children from avoiding mental health problems.

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>