Victoria L Fields1, Gnakub N Soke2, Ann Reynolds3, Lin H Tian2, Lisa Wiggins2, Matthew Maenner2, Carolyn DiGuiseppi4, Tanja V E Kral5, Kristina Hightshoe6, Christine Ladd-Acosta7, Laura A Schieve2. 1. Epidemic Intelligence Service Officer, Centers for Disease Control and Prevention, USA; National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: ish7@cdc.gov. 2. National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA. 3. Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. 4. Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. 5. School of Nursing and Perelman School of Medicine, Department of Biobehavioral Health Sciences, University of Pennsylvania, Philadelphia, PA, USA. 6. Department of Psychiatry, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA. 7. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Abstract
BACKGROUND: Pica, the repeated ingestion of nonfood items, can result in gastrointestinal (GI) outcomes. Children with autism spectrum disorder (ASD) and other developmental disabilities (DDs) are disproportionately affected by both pica and GI symptoms. Study of the inter-relationship between pica, GI symptoms, and ASD/DD is limited. OBJECTIVE/HYPOTHESIS: We assessed associations between pica and GI symptoms in preschool-aged children with and without ASD and other (non-ASD) DDs in the Study to Explore Early Development. METHODS: Our sample included children with ASD (n = 1244), other DDs (n = 1593), and population (POP) controls (n = 1487). Data to define final case-control status, pica, and GI symptoms were from standardized developmental assessments/questionnaires. Prevalence ratios, adjusted for sociodemographic factors (aPRs), and 95% confidence intervals were derived from modified Poisson regression. RESULTS: Within each group (ASD, DD, POP) and for the total sample, pica was associated with vomiting (aPR for total sample 2.6 [1.7, 4.0]), diarrhea (1.8 [1.4, 2.2]), and loose stools (1.8 [1.4, 2.2]). In the DD group, pica was associated with constipation (1.4 [1.03, 1.9]) and pain on stooling (1.8 [1.2, 2.6]). In analyses of the subgroup without pica, increases in GI symptoms were still evident in the ASD and DD groups compared to POP group. CONCLUSION: These findings highlight an important adverse effect of pica, GI symptoms, in children with and without ASD and DDs; nonetheless, pica does not fully explain the increased risk for GI symptoms among children with ASD and DDs. These findings inform the specialized healthcare needs of children with ASD and other DDs.
BACKGROUND: Pica, the repeated ingestion of nonfood items, can result in gastrointestinal (GI) outcomes. Children with autism spectrum disorder (ASD) and other developmental disabilities (DDs) are disproportionately affected by both pica and GI symptoms. Study of the inter-relationship between pica, GI symptoms, and ASD/DD is limited. OBJECTIVE/HYPOTHESIS: We assessed associations between pica and GI symptoms in preschool-aged children with and without ASD and other (non-ASD) DDs in the Study to Explore Early Development. METHODS: Our sample included children with ASD (n = 1244), other DDs (n = 1593), and population (POP) controls (n = 1487). Data to define final case-control status, pica, and GI symptoms were from standardized developmental assessments/questionnaires. Prevalence ratios, adjusted for sociodemographic factors (aPRs), and 95% confidence intervals were derived from modified Poisson regression. RESULTS: Within each group (ASD, DD, POP) and for the total sample, pica was associated with vomiting (aPR for total sample 2.6 [1.7, 4.0]), diarrhea (1.8 [1.4, 2.2]), and loose stools (1.8 [1.4, 2.2]). In the DD group, pica was associated with constipation (1.4 [1.03, 1.9]) and pain on stooling (1.8 [1.2, 2.6]). In analyses of the subgroup without pica, increases in GI symptoms were still evident in the ASD and DD groups compared to POP group. CONCLUSION: These findings highlight an important adverse effect of pica, GI symptoms, in children with and without ASD and DDs; nonetheless, pica does not fully explain the increased risk for GI symptoms among children with ASD and DDs. These findings inform the specialized healthcare needs of children with ASD and other DDs.
Authors: Diana E Schendel; Carolyn Diguiseppi; Lisa A Croen; M Daniele Fallin; Philip L Reed; Laura A Schieve; Lisa D Wiggins; Julie Daniels; Judith Grether; Susan E Levy; Lisa Miller; Craig Newschaffer; Jennifer Pinto-Martin; Cordelia Robinson; Gayle C Windham; Aimee Alexander; Arthur S Aylsworth; Pilar Bernal; Joseph D Bonner; Lisa Blaskey; Chyrise Bradley; Jack Collins; Casara J Ferretti; Homayoon Farzadegan; Ellen Giarelli; Marques Harvey; Susan Hepburn; Matthew Herr; Kristina Kaparich; Rebecca Landa; Li-Ching Lee; Brooke Levenseller; Stacey Meyerer; Mohammad H Rahbar; Andria Ratchford; Ann Reynolds; Steven Rosenberg; Julie Rusyniak; Stuart K Shapira; Karen Smith; Margaret Souders; Patrick Aaron Thompson; Lisa Young; Marshalyn Yeargin-Allsopp Journal: J Autism Dev Disord Date: 2012-10
Authors: Timothy Buie; Daniel B Campbell; George J Fuchs; Glenn T Furuta; Joseph Levy; Judy Vandewater; Agnes H Whitaker; Dan Atkins; Margaret L Bauman; Arthur L Beaudet; Edward G Carr; Michael D Gershon; Susan L Hyman; Pipop Jirapinyo; Harumi Jyonouchi; Koorosh Kooros; Rafail Kushak; Pat Levitt; Susan E Levy; Jeffery D Lewis; Katherine F Murray; Marvin R Natowicz; Aderbal Sabra; Barry K Wershil; Sharon C Weston; Lonnie Zeltzer; Harland Winter Journal: Pediatrics Date: 2010-01 Impact factor: 7.124
Authors: Micah O Mazurek; Roma A Vasa; Luther G Kalb; Stephen M Kanne; Daniel Rosenberg; Amy Keefer; Donna S Murray; Brian Freedman; Lea Ann Lowery Journal: J Abnorm Child Psychol Date: 2013-01
Authors: Ann M Reynolds; Gnakub N Soke; Katherine R Sabourin; Lisa A Croen; Julie L Daniels; M Daniele Fallin; Tanja V E Kral; Li- Ching Lee; Craig J Newschaffer; Jennifer A Pinto-Martin; Laura A Schieve; Amy Sims; Lisa Wiggins; Susan E Levy Journal: J Autism Dev Disord Date: 2021-01-04