| Abstract | Ciljevi: Cilj ovog istraživanja bio je istražiti udio značajnih perinatalnih događaja, pojedinih kliničkih slika, komorbiditeta i terapijskih opcija u djece s poremećajima iz spektra autizma u Klinici za dječje bolesti KBC-a Split.
Materijali i metode: Provedeno je retrospektivno istraživanje u kojem su ispitanici djeca s poremećajima iz spektra autizma pregledana ili hospitalizirana u Klinici za dječje bolesti KBC-a Split u trogodišnjem razdoblju, od 1. siječnja 2021. do 31. prosinca 2023. godine.
Rezultati: U ovom istraživanju je uočen postotak patologija trudnoće od 50% u djece s ASD-om. Prvi simptomi ASD-a se najčešće primijete u 18. mjesecu života kao zastoj razvoja govora. Najčešći komorbiditeti su poremećaji prehrane (52,9%), poremećaji spavanja (37,9%), epilepsija (28%) i psihijatrijski poremećaji (26,5%). U polovice pacijenata su prisutni promijenjeni nalazi EEG-a, dok su znatno manje prisutne strukturne promjene u sklopu MR nalaza (16,2%). Genetska obrada je bila pozitivna u polovice testiranih pacijenata. Najčešće primjenjivani lijekovi su antipsihotici (43,3%) i antiepileptici (38,6%). Omjer muške i ženske djece s ASD-om je 3,5:1. Statistički značajnije su prisutni eholalija (P = 0,04) i poremećaji senzorne integracije (P = 0,044) u ženskom spolu, dok u muškom psihijatrijske bolesti (P = 0,028) i stereotipije (P = 0,030). EEG promjene kod djece s ASD-om, a bez epilepsije statistički su povezane s većom stopom simptoma psihomotornog nemira (P = 0,024) i manirizma (P = 0,08). Epilepsija je statistički povezana s većim stupnjem intelektualnog deficita (P =0,009), smanjene fiksiranosti (P = 0,025) i poremećaja kretnji (P = 0,04).
Zaključci: Patologija trudnoće se nalazila u polovice djece s ASD-om. Od dijagnostičkih testova najčešći pozitivni rezultati su u EEG-u i genetičkim pretragama. Djeca s ASD-om koriste od lijekova najčešće antipsihotike i antiepileptike. Vrlo često su rano uključeni u razvojnu podršku. Omjer između muškog i ženskog spola ASD-a je 3,5:1, a razlikuju se po statistički značajno većoj prisutnosti psihijatrijskih poremećaja i stereotipija u muške, i eholalije i poremećaja senzorne integracije u ženske djece. EEG promjene bez epilepsije su povezane s većom učestalosti simptoma psihomotornog nemira i manirizma, dok epilepsija dodatno utječe na gori ishod intelektualne funkcije, smanjenja fiksiranosti i povećanja poremećaja kretnje. |
| Abstract (english) | Objectives: The aim of this study was to investigate the percentages of significant perinatal events, symptoms, comorbidities and therapeutic options in children with autism spectrum disorders at the Department of Pediatrics, University Hospital of Split.
Materials and methods: A retrospective study was conducted on children with ASD examined or hospitalized at the Department of Pediatrics, University Hospital of Split, from January 1st 2021. to December 31st 2023.
Results: In this study, a percentage of pregnancy pathologies of 50% was observed in children with ASD. Most often, the first symptoms of ASD were seen in the 18th month of life as a delay in speech development. The most common comorbidities in order of frequency are: eating disorders (52.9%), sleep disorders (37.9%), epilepsy (28%) and psychiatric disorders (26.5%). Altered EEG findings are present in half of the patients, while structural changes are significantly less present as part of MR findings (16.2%). Genetic processing was positive in half of the tested patients. The most frequently used drugs are antipsychotics (43.3%) and antiepileptics (38.6%). The ratio of male to female children with ASD is 3.5:1. Echolalia (P = 0.04) and disorders of sensory integration (P = 0.044) are more significant in females, while psychiatric illness (P = 0.028) and stereotypies (P = 0.030) are present in males. EEG changes without epilepsy were statistically associated with a higher rate of symptoms of hyperactivity (P = 0.024) and mannerism (P = 0.08). Epilepsy is associated with a higher degree of intellectual deficit (P = 0.009), reduced fixations (P = 0.025) and movement disorders (P = 0.04). Conclusions: Pregnancy pathology was found in half of the children with ASD. We also confirmed the hypothesis of frequent comorbidities in ASD. Of the diagnostic tests, the most common positive results are in EEG and genetic tests. Children with ASD mainly use antipsychotics and antiepileptics. Very often they were involved early in development support. The ratio between male and female ASDs is 3.5:1, and they differ in the statistically significant presence of psychiatric disorders and stereotypies in male children, echolalia and sensory integration disorders in female children. EEG changes without epilepsy are associated with a higher frequency of symptoms of hyperactivity and mannerism, while epilepsy affects a worse outcome of intellectual function, a decrease in fixation and an increase in movement disorders. |
