Association Between Assisted Reproductive Technology Conception and Autism in California, 1997-2007
Association Between Assisted Reproductive Technology Conception and Autism in California, 1997-2007
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DOI：
10.2105/ajph.2014.302383
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发表时间：
2015-05-01
影响因子：
12.7
通讯作者：
Bearman, Peter
中科院分区：
文献类型：
--
作者：
Fountain, Christine;Zhang, Yujia;Bearman, Peter
目标。我们在加州出生的人口样本中评估了辅助生殖技术(ART)和诊断出的自闭症之间的联系。我们进行了一项观察性队列研究，使用了1997年至2007年加州出生主档案、1997年至2011年加州发展服务部自动病例数量以及1997年至2007年疾病控制和预防中心的全国活产ART监测系统的相关记录。参与者均为5 926 251名活产儿，包括48 865名ART起源的婴儿和32 922名由发展服务部诊断为孤独症的病例。我们比较了使用抗逆转录病毒治疗和不使用抗逆转录病毒治疗的新生儿自闭症的发生率。在整个人口中，ART组被诊断为自闭症的发生率是非ART组的两倍。排除不太可能使用抗逆转录病毒疗法的母亲，这种相关性被削弱了；对人口统计和不利的产前和围产期结局进行调整，大大降低了这种相关性，尽管在20至34岁的母亲中，统计学意义仍然存在。ART和自闭症之间的联系主要是通过不良的产前和围产期结局以及多胎来解释的。
Objectives. We assessed the association between assisted reproductive technology (ART) and diagnosed autistic disorder in a population-based sample of California births.Methods. We performed an observational cohort study using linked records from the California Birth Master Files for 1997 through 2007, the California Department of Developmental Services autismcaseload for 1997 through 2011, and the Centers for Disease Control and Prevention's National ART Surveillance System for live births in 1997 through 2007. Participants were all 5 926 251 live births, including 48 865 ART-originated infants and 32 922 cases of autism diagnosed by the Department of Developmental Services. We compared births originated using ART with births originated without ART for incidence of autism.Results. In the full population, the incidence of diagnosed autism was twice as high for ART as non-ART births. The association was diminished by excluding mothers unlikely to use ART; adjustment for demographic and adverse prenatal and perinatal outcomes reduced the association substantially, although statistical significance persisted for mothers aged 20 to 34 years.Conclusions. The association between ART and autism is primarily explained by adverse prenatal and perinatal outcomes and multiple births.