Acetaminophen, antibiotics, ear infection, breastfeeding, vitamin D drops, and autism: an epidemiological study.
Acetaminophen, antibiotics, ear infection, breastfeeding, vitamin D drops, and autism: an epidemiological study.
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DOI：
10.2147/ndt.s158811
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发表时间：
2018
影响因子：
3.2
通讯作者：
Bell KR
中科院分区：
文献类型：
--
作者：
Bittker SS;Bell KR
虽然许多研究已经检查了自闭症谱系障碍（ASD）的环境风险因素，但大部分研究重点都集中在产前或围产期因素上。然而，出生后的环境也可能影响ASD的风险。确定一组五个产后变量是否与ASD相关。这些变量是：对乙酰氨基酚暴露、抗生素暴露、耳部感染发生率、母乳喂养持续时间缩短和口服维生素D滴剂消耗量减少。进行了一次基于互联网的调查。参与者是居住在美国的父母，至少有一个3至12岁的亲生子女。潜在的参与者通过社交媒体、网站和邮件列表上的帖子了解了调查情况，并有机会参加抽奖。参与者也通过互动自闭症网络招募。共有1，741份完整的调查回复。排除后，仍有1，001份回复与ASD儿童相关（病例），514份回复与没有ASD的儿童相关（对照）。在这个数据集中，产后对乙酰氨基酚的剂量（校正比值比[aOR] 1.016，CI：1.003-1.032，p=0.026），产后抗生素疗程（aOR 1.103，CI：1.046-1.168，p<0.001），产后耳部感染发生率（aOR 1.137，CI：1.046-1.236，p=0.003）和母乳喂养持续时间缩短（aOR 0.948，CI：0.932-0.965，p<0.001）均与ASD相关。经母乳喂养和人口统计学调整后，也发现口服维生素D滴剂暴露与ASD之间存在弱相关性（aOR 1.025，CI：0.995-1.056，p=0.102）。这项研究增加了证据表明，产后对乙酰氨基酚的使用，产后抗生素的使用，耳部感染的发生率和早期断奶与ASD风险增加有关。它还发现，当调整母乳喂养和人口统计学时，产后口服维生素D滴剂与ASD的相关性较弱。
While many studies have examined environmental risk factors for autism spectrum disorder (ASD), much of the research focus has been on prenatal or perinatal factors. Yet, the postnatal environment may affect the risk of ASD as well. To determine whether a set of five postnatal variables are associated with ASD. These variables are: acetaminophen exposure, antibiotic exposure, incidence of ear infection, decreased duration of breastfeeding, and decreased consumption of oral vitamin D drops. An Internet-based survey was conducted. Participants were parents living in the USA with at least one biological child between 3 and 12 years of age. Potential participants were informed about the survey via postings on social media, websites, and listservs and were offered an opportunity to participate in a raffle as well. Participants were also recruited through the Interactive Autism Network. There were 1,741 completed survey responses. After exclusions, there remained 1,001 responses associated with children with ASD (cases) and 514 responses associated with children who do not have ASD (controls). In this data set, doses of postnatal acetaminophen (adjusted odds ratio [aOR] 1.016, CI: 1.003–1.032, p=0.026), courses of postnatal antibiotics (aOR 1.103, CI: 1.046–1.168, p<0.001), incidence of postnatal ear infection (aOR 1.137, CI: 1.046–1.236, p=0.003), and decreased duration of breastfeeding (aOR 0.948, CI: 0.932–0.965, p<0.001) are all associated with ASD when adjusted for eight demographic variables. A weak association between oral vitamin D drop exposure and ASD was also found when adjusted for breastfeeding and demographics (aOR 1.025, CI: 0.995–1.056, p=0.102). This study adds to evidence that postnatal acetaminophen use, postnatal antibiotic use, incidence of ear infection, and early weaning are associated with an increased risk of ASD. It also finds that postnatal oral vitamin D drops are weakly associated with ASD when adjusted for breastfeeding and demographics.