Department of Epidemiology and Preventive Medicine, Jagiellonian University, Collegium Medicum, Krakow, Poland.
Pediatr Infect Dis J. 2010 May;29(5):397-400. doi: 10.1097/INF.0b013e3181c40a8a.
The first objective of the study was to determine whether there is a relationship between the measles-mumps-rubella (MMR) vaccination and autism in children. The second objective was to examine whether the risk of autism differs between use of MMR and the single measles vaccine.
Case-control study.
The 96 cases with childhood or atypical autism, aged 2 to 15, were included into the study group. Controls consisted of 192 children individually matched to cases by year of birth, sex, and general practitioners.
Data on autism diagnosis and vaccination history were from physicians. Data on the other probable autism risk factors were collected from mothers. Logistic conditional regression was used to assess the risk of autism resulting from vaccination. Assessment was made for children vaccinated (1) Before diagnosis of autism, and (2) Before first symptoms of autism onset. Odds ratios were adjusted to mother's age, medication during pregnancy, gestation time, perinatal injury and Apgar score.
For children vaccinated before diagnosis, autism risk was lower in children vaccinated with MMR than in the nonvaccinated (OR: 0.17, 95% CI: 0.06-0.52) as well as to vaccinated with single measles vaccine (OR: 0.44, 95% CI: 0.22-0.91). The risk for vaccinated versus nonvaccinated (independent of vaccine type) was 0.28 (95% CI: 0.10-0.76). The risk connected with being vaccinated before onset of first symptoms was significantly lower only for MMR versus single vaccine (OR: 0.47, 95% CI: 0.22-0.99).
The study provides evidence against the association of autism with either MMR or a single measles vaccine.
本研究的首要目的是确定麻疹-腮腺炎-风疹(MMR)疫苗接种与儿童自闭症之间是否存在关联。次要目的是检验 MMR 与单价麻疹疫苗的使用与自闭症风险之间是否存在差异。
病例对照研究。
本研究纳入了 96 例年龄在 2 至 15 岁的儿童自闭症或非典型自闭症患者作为病例组。对照组由 192 名年龄、性别和全科医生相匹配的儿童组成。
自闭症诊断和疫苗接种史数据由医生提供,其他可能的自闭症风险因素数据由母亲提供。采用逻辑条件回归评估接种疫苗引起自闭症的风险。评估了以下两种情况下儿童接种疫苗的情况:(1)在自闭症诊断之前,以及(2)在自闭症发病的首个症状出现之前。调整了母亲年龄、孕期用药、妊娠时间、围产期损伤和阿普加评分等因素的比值比。
对于在诊断前接种疫苗的儿童,与未接种疫苗的儿童相比,接种 MMR 疫苗的儿童自闭症风险较低(比值比:0.17,95%可信区间:0.06-0.52),与接种单价麻疹疫苗的儿童相比(比值比:0.44,95%可信区间:0.22-0.91)。无论疫苗类型如何,接种疫苗的儿童与未接种疫苗的儿童相比,风险比为 0.28(95%可信区间:0.10-0.76)。仅在 MMR 与单价疫苗之间,与发病前出现首个症状时接种疫苗相关的风险显著降低(比值比:0.47,95%可信区间:0.22-0.99)。
本研究结果提供了证据,表明自闭症与 MMR 或单价麻疹疫苗均无关联。