Table 4.
Comparison of the proportion of children with gastrointestinal symptoms (GIS) based on parent responses on the gastrointestinal questionnaire (GIS/PR) between children with an autism spectrum disorder (ASD), developmental delays (DD), and children from the general population (POP)
| GIS questionnaire only (GIS/PR) | Case | DD | POP | ASD vs DD |
ASD vs POP |
||
|---|---|---|---|---|---|---|---|
| (n = 656) n (%) | (n = 932) n (%) | (n = 837) n (%) | Crude OR (95% CI) | Adjusted OR (95% CI) | Crude OR (95% CI) | Adjusted OR (95% CI) | |
| Presence of any current GIS/PR | 227 (34.6) | 202 (22.1) | 101 (12.0) | 1.91 (1.62–2.26)* | 1.85 (1.54–2.22)* | 3.90 (3.07–4.95)* | 3.42 (2.11–5.54)* |
| Vomiting | 30 (4.6) | 29 (3.2) | 8 (0.9) | 1.49 (0.89–2.49) | 1.08 (0.56–2.08) | 5.01 (3.17–7.94)* | 2.04 (0.54–7.64) |
| Diarrhea | 66 (10.1) | 24 (2.6) | 13 (1.5) | 4.23 (2.69–6.66)* | 3.57 (2.40–5.30)* | 7.16 (4.83–10.61)* | 4.74 (2.70–8.31)* |
| Loose stools | 105 (16.0) | 50 (5.5) | 26 (3.1) | 3.36 (2.21–5.12)* | 2.73 (1.77–4.20)* | 6.00 (4.32–8.33)* | 4.04 (2.88–5.68)* |
| Constipation | 154 (23.5) | 149 (16.3) | 72 (8.5) | 1.61 (1.4–1.86)* | 1.53 (1.39–1.67)* | 3.29 (2.40–4.52)* | 2.58 (1.14–5.84)* |
| Loose alternating with Constipation | 94 (14.3) | 40 (4.4) | 19 (2.2) | 3.73 (2.69–5.17)* | 3.09 (2.05–4.65)* | 7.27 (5.54–9.54)* | 5.25 (3.73–7.39)* |
| Abdominal pain with meals | 33 (5.0) | 35 (3.8) | 19 (2.2) | 1.36 (0.88–2.10) | 1.75 (0.88–3.48) | 2.30 (1.61–3.29)* | 5.06 (2.39–10.74)* |
| Abdominal pain relieved by defecation | 50 (7.6) | 69 (7.6) | 37 (4.4) | 1.03 (0.77–1.38) | 1.43 (0.83–2.44) | 1.80 (1.21–2.69)* | 3.40 (1.20–9.60)* |
| Pain on stooling | 81 (12.3) | 77 (8.4) | 35 (4.1) | 1.56 (1.10–2.22)* | 1.86 (1.39–2.48)* | 3.26 (2.28–4.65)* | 4.29 (1.57–11.76)* |
| Gas | 105 (16.0) | 73 (8.0) | 30 (3.6) | 2.24 (1.48–3.40)* | 1.97 (1.42–2.74)* | 5.18 (3.67–7.31)* | 4.86 (2.44–9.67)* |
| Other | 35 (5.3) | 28 (3.1) | 6 (0.7) | 1.82 (1.03–3.21)* | 1.72 (0.78–3.81) | 7.88 (3.03–20.48)* | 5.46 (1.24–24.08)* |
| Current Treatment for Constipation | 105(16.0)a | 118(12.9)a | 64 (7.6)a | 1.30 (0.97–1.73) | 1.19 (0.90–1.57) | 2.29 (1.65–3.18)* | 2.21 (1.10–4.47)* |
| Past GI problems (no longer present) | 180(27.4)b | 177(19.4)b | 113(13.4)b | 1.65 (1.33–2.03)* | 1.76 (1.24–2.50)* | 2.53 (2.01–3.19)* | 3.50 (2.26–5.43)* |
|
GIS based on an algorithm combining gastrointestinal questionnaire and stool diary using the Bristol stool scale (GIS/PRSD) | |||||||
| Gastrointestinal symptom (GIS/PRSD) | Case | DD | POP | ASD vs DD |
ASD vs POP |
||
| (n = 335) n (%) | (n = 437) n (%) | (n = 480) n (%) | Crude OR (95% CI) | Adjusted OR (95% CI) | Crude OR (95% CI) | Adjusted OR (95% CI) | |
|
| |||||||
| Presence of any current GIS below | 169 (50.4) | 186 (42.6) | 147 (30.6) | 1.37 (1.20–1.57)* | 1.29 (1.07–1.56)* | 2.31 (1.99–2.68)* | 2.22 (1.56–3.14)* |
| Four or more stools per day | 5 (1.5) | 5(1.1) | 1 (0.2) | 1.31 (0.43–3.99) | 0.65 (0.29–1.49) | 7.26 (1.90–27.66)* | 11.18(2.37–52.77)* |
| Constipation (GIS/PRSD) | 80 (23.9) | 120 (27.5) | 102 (21.3) | 0.83 (0.69–1.00)* | 0.84 (0.67–1.05) | 1.16 (1.03–1.32)* | 1.48 (1.14–1.92)* |
| Loose stool or diarrhea | 34 (10.1) | 37 (8.5) | 30 (6.3) | 1.22 (0.84–1.77) | 1.03 (0.75–1.43) | 1.69 (1.19–2.41)* | 1.05 (0.48–2.28) |
| Vomiting | 25 (7.5) | 20 (4.6) | 8 (1.7) | 1.68 (1.06–2.67)* | 1.24 (0.80–1.93) | 4.76 (2.20–10.28)* | 2.30 (0.94–5.64) |
| Abdominal pain | 55 (16.4) | 52 (11.9) | 38 (7.9) | 1.45 (1.18–1.79)* | 1.62 (1.11–2.35)* | 2.28 (1.71–3.05)* | 2.48 (0.80–7.68) |
| Gas | 49 (14.6) | 32 (7.3) | 18 (3.8) | 2.17 (1.46–3.23)* | 1.71 (1.10–2.65)* | 4.40 (2.97–6.52)* | 4.01 (1.68–9.57)* |
All models are adjusted for maternal race/ethnicity, education level, age at child’s birth, child sex and Mullen Scales of Early Learning score, and accounted for correlation by enrollment site
ASD autism spectrum disorder, DD other developmental delays, POP children from the general population, constipation (GIS/PRSD): 2 or more hard stools/week, < 3 stools/week and at least one is hard, and/or use of a laxative or stool softener
p-value < 0.05
Percent calculated from total of 667 ASD, 936 DD, 849 POP
Percent calculated from total of 635 ASD, 913 DD, 837 POP