Fountain Christine, Zhang Yujia, Kissin Dmitry M, Schieve Laura A, Jamieson Denise J, Rice Catherine, Bearman Peter
Christine Fountain is with the Department of Sociology and Anthropology, Fordham University, New York, NY. Yujia Zhang, Dmitry M. Kissin, and Denise J. Jamieson are with the National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Laura A. Schieve and Catherine Rice are with the National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention. Peter Bearman is with the Interdisciplinary Center for Innovative Theory and Empirics, Columbia University, New York.
Am J Public Health. 2015 May;105(5):963-71. doi: 10.2105/AJPH.2014.302383. Epub 2015 Mar 19.
We assessed the association between assisted reproductive technology (ART) and diagnosed autistic disorder in a population-based sample of California births.
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 autism caseload 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.
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.
The association between ART and autism is primarily explained by adverse prenatal and perinatal outcomes and multiple births.
我们在加利福尼亚州出生人口的代表性样本中评估辅助生殖技术（ART）与自闭症诊断之间的关联。
我们进行了一项观察性队列研究，使用了1997年至2007年加利福尼亚州出生主档案、1997年至2011年加利福尼亚州发育服务部自闭症病例数以及疾病控制和预防中心1997年至2007年活产国家ART监测系统的关联记录。参与者为所有5926251例活产，包括48865例ART出生的婴儿和发育服务部诊断的32922例自闭症病例。我们比较了ART出生的婴儿和非ART出生的婴儿的自闭症发病率。
在整个人口中，ART出生婴儿的自闭症诊断发病率是非ART出生婴儿的两倍。通过排除不太可能使用ART的母亲，这种关联减弱；对人口统计学因素以及不良产前和围产期结局进行调整后，这种关联大幅降低，尽管20至34岁母亲的关联仍具有统计学意义。
ART与自闭症之间的关联主要由不良产前和围产期结局以及多胎妊娠来解释。
