PDF(Pubmed)
Abstract：
Studies evaluating the association between prenatal ultrasounds and autism spectrum disorder (ASD) have largely produced negative results. Concern remains due to the rising identification of children with ASD and ultrasound use.
To evaluate the association between prenatal ultrasound use and ASD.
We used data from the Study to Explore Early Development, a multisite case-control study of preschool-aged children with ASD implemented during 2007-2012. We recruited cases from children receiving developmental disability services and randomly selected population controls from birth records. ASD case status was based on in-person standardised assessments. We stratified analyses by pre-existing maternal medical conditions and pregnancy complications associated with increased ultrasound use (ultrasound indications) and used logistic regression to model case status by increasing ultrasound counts. For pregnancies with medical record data on ultrasound timing, we conducted supplementary tests to model associations by trimester of exposure.
Among 1524 singleton pregnancies, ultrasound indications were more common for ASD cases than controls; respectively, for each group, no indications were reported for 45.1% and 54.2% of pregnancies, while ≥2 indications were reported for 26.1% and 18.4% of pregnancies. The percentage of pregnancies with multiple ultrasounds varied by case status and the presence of ultrasound indications. However, stratified regression models showed no association between increasing ultrasound counts and case status, either for pregnancies without (aOR 1.01, 95% CI 0.92, 1.11) or with ultrasound indications (aOR 1.01, 95% CI 0.95, 1.08). Trimester-specific analyses using medical record data showed no association in any individual trimester.
We found no evidence that prenatal ultrasound use increases ASD risk. Study strengths included gold-standard assessments for ASD case classification, comparison of cases with controls, and a stratified sample to account for conditions associated both with increased prenatal ultrasound use and ASD.
To evaluate the association between prenatal ultrasound use and ASD.
We used data from the Study to Explore Early Development, a multisite case-control study of preschool-aged children with ASD implemented during 2007-2012. We recruited cases from children receiving developmental disability services and randomly selected population controls from birth records. ASD case status was based on in-person standardised assessments. We stratified analyses by pre-existing maternal medical conditions and pregnancy complications associated with increased ultrasound use (ultrasound indications) and used logistic regression to model case status by increasing ultrasound counts. For pregnancies with medical record data on ultrasound timing, we conducted supplementary tests to model associations by trimester of exposure.
Among 1524 singleton pregnancies, ultrasound indications were more common for ASD cases than controls; respectively, for each group, no indications were reported for 45.1% and 54.2% of pregnancies, while ≥2 indications were reported for 26.1% and 18.4% of pregnancies. The percentage of pregnancies with multiple ultrasounds varied by case status and the presence of ultrasound indications. However, stratified regression models showed no association between increasing ultrasound counts and case status, either for pregnancies without (aOR 1.01, 95% CI 0.92, 1.11) or with ultrasound indications (aOR 1.01, 95% CI 0.95, 1.08). Trimester-specific analyses using medical record data showed no association in any individual trimester.
We found no evidence that prenatal ultrasound use increases ASD risk. Study strengths included gold-standard assessments for ASD case classification, comparison of cases with controls, and a stratified sample to account for conditions associated both with increased prenatal ultrasound use and ASD.
摘要：
背景：评估产前超声检查与自闭症谱系障碍（ASD）之间关联的研究在很大程度上产生了阴性结果。由于ASD和超声使用儿童的认同度上升，人们仍然感到担忧。
目的：评估产前超声检查与ASD的相关性。
方法：我们使用来自研究的数据来探索早期发展，2007-2012年实施的一项针对ASD学龄前儿童的多中心病例对照研究。我们从接受发育障碍服务的儿童中招募了病例，并从出生记录中随机选择了人口对照。ASD病例状态基于现场标准化评估。我们根据与超声使用增加（超声适应症）相关的先前存在的产妇医疗状况和妊娠并发症进行了分层分析，并使用逻辑回归通过增加超声计数来模拟病例状态。对于有超声定时医疗记录数据的怀孕，我们根据暴露的三个月对模型关联进行了补充测试.
结果：在1524例单胎妊娠中，ASD病例的超声指征比对照组更常见；对于每个小组，45.1%和54.2%的妊娠没有适应症报告，而报告的≥2适应症分别为26.1%和18.4%的妊娠。多次超声检查的妊娠百分比因病例状态和超声适应症的存在而异。然而,分层回归模型显示增加的超声计数和病例状态之间没有关联，对于无超声指征(aOR1.01,95%CI0.92,1.11)或有超声指征(aOR1.01,95%CI0.95,1.08)的妊娠。使用医疗记录数据进行的特定于三个月的分析显示，在任何单独的三个月中都没有关联。
结论：我们没有发现产前超声检查增加ASD风险的证据。研究优势包括ASD病例分类的黄金标准评估，病例与对照的比较，和分层样本，以说明与产前超声使用增加和ASD相关的条件。
目的：评估产前超声检查与ASD的相关性。
方法：我们使用来自研究的数据来探索早期发展，2007-2012年实施的一项针对ASD学龄前儿童的多中心病例对照研究。我们从接受发育障碍服务的儿童中招募了病例，并从出生记录中随机选择了人口对照。ASD病例状态基于现场标准化评估。我们根据与超声使用增加（超声适应症）相关的先前存在的产妇医疗状况和妊娠并发症进行了分层分析，并使用逻辑回归通过增加超声计数来模拟病例状态。对于有超声定时医疗记录数据的怀孕，我们根据暴露的三个月对模型关联进行了补充测试.
结果：在1524例单胎妊娠中，ASD病例的超声指征比对照组更常见；对于每个小组，45.1%和54.2%的妊娠没有适应症报告，而报告的≥2适应症分别为26.1%和18.4%的妊娠。多次超声检查的妊娠百分比因病例状态和超声适应症的存在而异。然而,分层回归模型显示增加的超声计数和病例状态之间没有关联，对于无超声指征(aOR1.01,95%CI0.92,1.11)或有超声指征(aOR1.01,95%CI0.95,1.08)的妊娠。使用医疗记录数据进行的特定于三个月的分析显示，在任何单独的三个月中都没有关联。
结论：我们没有发现产前超声检查增加ASD风险的证据。研究优势包括ASD病例分类的黄金标准评估，病例与对照的比较，和分层样本，以说明与产前超声使用增加和ASD相关的条件。
