Measles, mumps, and rubella vaccination and bowel problems or developmental regression in children with autism: Population study
Measles, mumps, and rubella vaccination and bowel problems or developmental regression in children with autism: Population study
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DOI：
10.1136/bmj.324.7334.393
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发表时间：
2002-02-16
影响因子：
--
通讯作者：
Stowe, J
中科院分区：
文献类型：
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作者：
Taylor, B;Miller, E;Stowe, J
目的调查麻疹、腮腺炎和风疹（MMR）疫苗接种是否与自闭症儿童的肠道问题和发育倒退有关，寻找自闭症“新变体”形式的证据。设计人群研究，病例记录综述与独立记录的疫苗数据相关联。在伦敦东北部设置了五个卫生区。参与者278名患有核心自闭症的儿童和195名患有非典型自闭症的儿童，主要是通过计算机残疾登记识别的，出生于1979年至1998年之间。记录的肠道问题持续至少3个月，报告的儿童发育倒退的年龄（这是一个特征），以及这些与MMR疫苗接种的关系。结果自1997年（包括1988年10月引入MMR疫苗接种）以来的20年间，出现发育倒退（25%）或肠道症状（17%）的儿童比例无显著变化（P值分别为0.50和0.47）。在父母开始关注他们的发育之前接种MMR疫苗的儿童（MMR可能导致或触发自闭症的发育或肠道问题），与那些在父母关注之后才接种疫苗的儿童和那些没有接种MMR疫苗的儿童相比，肠道问题或退化率没有显著差异。非特异性肠道问题与自闭症儿童的退化之间可能存在关联，但这与MMR疫苗接种无关。结论：这些发现并没有支持MMR疫苗与发育倒退和肠道问题相关的自闭症“新变异”形式，也没有进一步证据表明MMR疫苗与自闭症的发生有关。
Objectives To investigate whether measles, mumps, and rubella (MMR) vaccination is associated with bowel problems and developmental regression in children with autism, looking for evidence of a "new variant" form of autism.Design Population study with case note review linked to independently recorded vaccine data.Setting Five health districts in north east London.Participants 278 children with core autism and 195 with atypical autism, mainly identified froth computerised disability registers and born between 1979 and 1998.Main outcome measures Recorded bowel problems lasting at least three months, age of reported regression of the child's development where it was a feature, and relation of these to MMR vaccination.Results The proportion of children with developmental regression (25% overall) or bowel symptoms (17%) did not change significantly (P value for trend 0.50 and 0.47, respectively) during the 20 years from 197 9, a period which included the introduction of MMR vaccination in October 1988. No significant difference was found in rates of bowel problems or regression in children who received the MMR vaccine before their parents became concerned about their development (where MMR might have caused or triggered the autism with regression or bowel problem), compared with those who received it only after such concern and those who had not received the MMR vaccine. A possible association between non-specific bowel problems and regression in children with autism was seen but this was unrelated to MMR vaccination.Conclusions These findings provide no support for an MMR associated "new variant" form of autism with developmental regression and bowel problems, and further evidence against involvement of MMR vaccine in the initiation of autism.