Real-world evidence from a multi-center pediatric network: greenness exposure and autism spectrum disorder in urban China.

Researchers screened over 13,000 young children in a major Chinese city to see if living in greener areas affects autism rates. They found that boys and older children were more likely to be diagnosed with autism, but living near more green spaces didn't seem to make a difference. The study shows how real-world data from hospitals can help us better understand autism and improve how we screen for it.

This large-scale screening study examined 13,458 children aged 0-52 months across 20 primary care hospitals in urban China to investigate potential associations between environmental greenness exposure and autism spectrum disorder (ASD) prevalence. The study found an estimated ASD prevalence of 0.55% and confirmed that being male and older age were significantly associated with higher odds of ASD diagnosis. However, the primary research question regarding greenness exposure showed no statistically significant association with ASD diagnosis. The authors suggest their real-world data collection methods could improve ASD screening approaches and inform future environmental health research in urban settings.

Results support continued focus on established demographic factors in ASD screening. Real-world data collection methods may enhance screening programs. Environmental greenness appears less relevant for ASD risk assessment, though replication studies needed.

Single geographic location limits generalizability. Environmental exposure assessment methods not detailed. Cross-sectional design cannot establish causation. Screening methodology and diagnostic criteria not fully described in abstract.

Childhood autism spectrum disorder (ASD) is a global public health concern and its prevalence is increasing rapidly in developing countries such as China. The mechanism behind ASD development remains unclear. Greenness exposure is reportedly associated with various health outcomes, however, the connection between greenness exposure and ASD is relatively unexplored. We designed a two-stage screening process and conducted city-wide screening for early childhood ASD to investigate the association between greenness exposure and ASD prevalence in a megacity in southwest China.

We screened 13,458 children from 0-52 months through 20 local primary care hospitals and the estimated ASD prevalence was 0.55%. We matched greenness exposure, air pollution exposure, and weather condition with ASD diagnosis outcomes based on the study subject's geographic information. Gender (male) and age (older) were significantly associated with higher odds of being diagnosed with ASD. Although the association between ASD diagnosis and greenness was not statistically significant, real-world data may help improve ASD screening methods and guide future studies.

Our findings highlight the potential role of real-world environmental and health data in informing sustainable urban and pediatric health policies.