Study About Prenatal, Perinatal Risk Factors And PGR Polymorphisms In Chinese Han Autistic Children With Developmental Regression

Chapter IPrenatal and perinatal risk factors associated with autism with developmental regressionObjects(1) To explore the differences between the autistic children with or without developmental regression in demographics and clinical characteristics.(2) To explore the prenatal and perinatal risk factors of autistic children with developmental regressionMethods(1)573autistic children fulfilled with DSM-IV-TR diagnostic criteria were recruited, they were assigned into regression subgroup (223cases) and non-regression subgroup (374cases) according to the presence or absence of developmental regression. Demographics and clinical characteristics of the two subgroups and the control group were analysed by using ANOVA and Chi-square test (Fisher’s exact test or rank sum test was used when necessary).(2) We adopted a multiple logistic regression to explore some potential prenatal and perinatal risk factors of autistic children with developmental regression after comparing the differences of these related factors among regression autism, non-regression autism and normal control.Results(1) There were174males and35females in the control group, mean age was55.48±12.71months. In the regressive group, there were193males and30females, mean age was57.57±12.05months, mean onset age was26.34±9.37 months.324males and50females were included in non-regressive group, mean age was57.33±13.89months, and mean onset age was22.91±9.37months. There was no statistics difference among the three groups in age and gender distribution. The onset age was older in regressive group than non-regressive group(t=0.220, P=0.719).(2) The mean score of Autistic Behavior Checklist (ABC) of84cases in regressive group was70.48±20.30, which was higher than the mean score of90cases in non-regressive group (70.48±20.30)(t=2.538, P=0.012).(3) Parents of non-regressive group autistic children reported the most common first detected symptoms was Delay in starting to talk (63.9%), followed by Delay in starting to walk (21.2%) and Aggressive behavior (3.6%), while the parents of regressive group children reported the most common first detected symptoms was Delay in starting to talk (39.9%), Do not play games and refuse to take part in group games (19.6%), Regression in language skills and acquired languages loss (12.9%).(4) The multiple logistic regression analysis showed that in the selected variables the number of abortion, threatened abortion, therapeutic drug, emotion during pregnancy, premature rupture of fetal membranes and prolonged labor were the risk factors to the regressive autism when compared to the normal controls. While using oxytocin was a protective factor to regressive autism. Furthermore, we detected that threatened abortion and severe pregnancy reaction were associated with developmental regression when compared with the non-regressive autism.Conclusion(1) When compared to non-regressive autism, the onset age was older and the severity of symptoms was more severe of regressive autism.(2) The multiple logistic regression analysis showed that in the selected variables the number of abortion, threatened abortion, therapeutic drug, emotion during pregnancy, premature rupture of fetal membranes, prolonged labor and severe pregnancy reaction were the risk factors to the regressive autism. While using oxytocin was a protective factor to regressive autism..(3) Our result did not detect any relations between induced abortion, fever during pregnancy, severe trauma, birth weight and regressive autism. Chapter ⅡPGR single nucleotide polymorphisms in Chinese Han autistic children with developmental regressionObjectsTo explore the association of PGR single nucleotide polymorphisms with Chinese Han autistic children with developmental regressionMethods300autistic children fulfilled with DSM-IV-TR criteria and734normal controls from the autism genetic resource of State Key Laboratory of Medical Genetics were divided into regressive group, non-regressive group or control group. SNP genotype data of PGR (also containing the SNPs in the50kd region on both sides next to the gene) was selected from a prior Genome Wide Association study data. SPSS17.0software was used to perform a Chi square test (Fisher’s exact test was used when necessary) to compare the differences of allelic and genotypic distribution of19SNPs in PGR among the above three groups (regressive group vs. non-regressive group vs. control group).ResultThere was no significant difference in genotypic and allelic distribution among the three groups (all P>0.05)ConclusionPGR is not likely to be a susceptibility gene of regressive autism.