Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Kopernika 7a, 31-034 Krakow, Poland.
Vaccine. 2013 May 24;31(22):2551-7. doi: 10.1016/j.vaccine.2013.03.057. Epub 2013 Apr 12.
The aim of the study was to examine the hypothesis that MMR exposure has a negative influence on cognitive development in children. Furthermore, MMR was compared to single measles vaccine to determine the potential difference of these vaccines safety regarding children's cognitive development.
The prospective birth cohort study with sample consisted of 369 infants born in Krakow. Vaccination history against measles (date and the type of the vaccine) was extracted from physicians' records. Child development was assessed using the Bayley Scales of Infant Development (BSID-II) up to 3rd year of life, Raven test in 5th and 8th year and Wechsler (WISC-R) in 6th and 7th year. Data on possible confounders came from mothers' interview, medical records and analyses of lead and mercury level at birth and at the end of 5th year of life. Linear and logistic regression models adjusted for potential confounders were used to assess the association.
No significant differences in cognitive and intelligence tests results were observed between children vaccinated with MMR and those not vaccinated up to the end of the 2nd year of life. Children vaccinated with MMR had significantly higher Mental BSID-II Index (MDI) in the 36th month than those vaccinated with single measles vaccine (103.8±10.3 vs. 97.2±11.2, p=0.004). Neither results of Raven test nor WISC-R were significantly different between groups of children vaccinated with MMR and with single measles vaccine. After standardization to child's gender, maternal education, family economical status, maternal IQ, birth order and passive smoking all developmental tests were statistically insignificant.
The results suggest that there is no relationship between MMR exposure and children's cognitive development. Furthermore, the safety of triple MMR is the same as the single measles vaccine with respect to cognitive development.
本研究旨在检验以下假设，即麻疹、腮腺炎、风疹（MMR）疫苗接种会对儿童认知发展产生负面影响。此外，我们将 MMR 与单价麻疹疫苗进行比较，以确定这两种疫苗在儿童认知发育方面的安全性差异。
本前瞻性出生队列研究的样本由 369 名出生于克拉科夫的婴儿组成。从医生的记录中提取了针对麻疹的疫苗接种史（日期和疫苗类型）。采用贝利婴幼儿发展量表（BSID-II）评估儿童在 3 岁之前的发育情况，瑞文标准推理测验（5 岁和 8 岁）和韦氏儿童智力量表（WISC-R）（6 岁和 7 岁）。来自母亲访谈、病历和出生时及 5 岁末的铅和汞水平分析的潜在混杂因素的数据。使用调整了潜在混杂因素的线性和逻辑回归模型来评估关联。
在第 2 年末之前，接受 MMR 疫苗和未接种 MMR 疫苗的儿童之间，认知和智力测试结果没有显著差异。接受 MMR 疫苗接种的儿童在第 36 个月的精神 BSID-II 指数（MDI）明显高于接受单价麻疹疫苗接种的儿童（103.8±10.3 vs. 97.2±11.2，p=0.004）。接受 MMR 疫苗和单价麻疹疫苗接种的儿童之间的瑞文测试和 WISC-R 结果均无显著差异。在标准化为儿童性别、母亲教育程度、家庭经济状况、母亲智商、出生顺序和被动吸烟后，所有发育测试均无统计学意义。
结果表明，MMR 暴露与儿童认知发展之间没有关系。此外，在认知发育方面，三联 MMR 的安全性与单价麻疹疫苗相同。
