No evidence for links between autism, MMR and measles virus
No evidence for links between autism, MMR and measles virus
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DOI：
10.1017/s0033291703001259
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发表时间：
2004-04-01
影响因子：
6.9
通讯作者：
Fombonne, E
中科院分区：
文献类型：
--
作者：
Chen, W;Landau, S;Fombonne, E
背景我们研究了在英国，是否有自闭症（AD）的风险增加以下暴露，在生命早期：（1）野麻疹;（2）减毒活麻疹，单独或组合作为MMR;和（3）MMR内腮腺炎菌株的改变。我们对1959-93年间出生的2407名AD受试者进行了时间趋势分析;作为比较，对1966-93年间出生的4640名唐氏综合症（DS）受试者进行了分析。在1968-86年间，我们将AD和DS出生率的变化与野生麻疹发病率相关。在1959-93年期间，我们测试了长期AD出生趋势的突然变化，以了解引入以下疫苗的影响：（1）1968年的单价麻疹疫苗;（2）1988年的MMR免疫接种;和（3）1992年从混合使用Urabe MMR到单独使用Jeryl-Lynn MMR的“一夜之间转换”。发病率比（IRR）被用来作为相关性的措施。我们发现AD出生和暴露（产前和产后18个月）麻疹感染的人口率之间没有显着的相关性，并且AD出生的增加与单价麻疹和MMR疫苗的引入以及腮腺炎病毒株的变化无关。在1987年以后出生的队列中，AD出生率意外降低了21%（95%CI 6-9-33-3%; P=0.005）。未检测到暴露于野麻疹和接种单价麻疹疫苗以及MMR的Urabe或Jeryl-Lynn变体后AD的风险增加。检测到的AD出生减少的确切含义尚不清楚。鉴于其相关性设计，我们的研究不能排除MMR的罕见并发症。
Background. We examined whether, in the UK, there is an increased risk of autism (AD) following exposures, in early life, to: (1) wild measles; (2) live attenuated measles, alone or in combination as MMR; and (3) the alteration of the mumps strain within MMR.Method. We conducted time trend analyses of 2407 AD subjects born between 1959-93; and for comparison, 4640 Down's syndrome (DS) subjects born between 1966-93. Between 1968-86, we correlated variations in AD and DS births with wild measles incidence. Between 1959-93, we tested for abrupt changes in the long-term AD birth trend for the effects of introducing: (1) monovalent measles vaccines in 1968; (2) MMR immunization in 1988; and (3) the 'overnight switch' from mixed use of Urabe MMR to exclusive use of Jeryl-Lynn MMR in 1992. Incidence rate ratios (IRRs) were used as measures of association.Results. We found no significant association between AD births and exposure (prenatal and postnatal up to 18 months age) to population rates of measles infections, and no 'step-up' increase in AD births associated with the introduction of monovalent measles and MMR vaccines, and changing mumps strain. An unexpected reduction in AD births of 21% (95% CI 6-9-33-3%; P=0.005) among the post-1987 birth cohorts was detected.Conclusion. No increased risk of AD following exposures to wild measles and vaccinations with monovalent measles, and Urabe or Jeryl-Lynn variants of MMR was detected. The precise meaning of the detected AD births reduction is unclear. Our study cannot exclude rare complications of MMR, given its correlational design.