title: Association between Prenatal Environmental Factors and Child Autism: A Case Control Study in Tianjin, China.
abstract: OBJECTIVE
  To investigate the association between autism and prenatal environmental risk factors.
  
  
  METHODS
  A case-control study was conducted among 193 children with autism from the special educational schools and 733 typical development controls matched by age and gender by using questionnaire in Tianjin from 2007 to 2012. Statistical analysis included quick unbiased efficient statistical tree (QUEST) and logistic regression in SPSS 20.0.
  
  
  RESULTS
  There were four predictors by QUEST and the logistic regression analysis, maternal air conditioner use during pregnancy (OR=0.316, 95% CI: 0.215-0.463) was the single first-level node (χ²=50.994, P=0.000); newborn complications (OR=4.277, 95% CI: 2.314-7.908) and paternal consumption of freshwater fish (OR=0.383, 95% CI: 0.256-0.573) were second-layer predictors (χ²=45.248, P=0.000; χ²=24.212, P=0.000); and maternal depression (OR=4.822, 95% CI: 3.047-7.631) was the single third-level predictor (χ²=23.835, P=0.000). The prediction accuracy of the tree was 89.2%.
  
  
  CONCLUSIONS
  The air conditioner use during pregnancy and paternal freshwater fish diet might be beneficial for the prevention of autism, while newborn complications and maternal depression might be the risk factors.
authors.affiliation: Dept. Maternal, Child & Adolescence Health of School of Public Health, Tianjin Medical University, Tianjin 300070, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Gao
authors.affiliation: Dept. Maternal, Child & Adolescence Health of School of Public Health, Tianjin Medical University, Tianjin 300070, China.
authors.forename: Qian Qian
authors.initials: QQ
authors.lastname: Xi
authors.affiliation: Program in Public Health and department of Epidemiology, University of California, Irvine, USA.
authors.forename: Jun
authors.initials: J
authors.lastname: Wu
authors.affiliation: Dept. Maternal, Child & Adolescence Health of School of Public Health, Tianjin Medical University, Tianjin 300070, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Han
authors.affiliation: Dept. Maternal, Child & Adolescence Health of School of Public Health, Tianjin Medical University, Tianjin 300070, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Dai
authors.affiliation: Dept. Maternal, Child & Adolescence Health of School of Public Health, Tianjin Medical University, Tianjin 300070, China.
authors.forename: Yuan Yuan
authors.initials: YY
authors.lastname: Su
authors.affiliation: Dept. Maternal, Child & Adolescence Health of School of Public Health, Tianjin Medical University, Tianjin 300070, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000389:Air Conditioning; D000397:Air Pollution / Q000009:adverse effects; D001321:Autistic Disorder / Q000453:epidemiology / Q000209:etiology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D036861:Delivery, Obstetric / Q000009:adverse effects / Q000379:methods; D003863:Depression / Q000150:complications; D004032:Diet; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D007182:Income; D016015:Logistic Models; D008297:Male; D018811:Maternal Exposure; D007744:Obstetric Labor Complications / Q000453:epidemiology; D018812:Paternal Exposure; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D012307:Risk Factors; D011795:Surveys and Questionnaires
keywords: Autism; Case-control study; Child health; Environmental risk factors