Su XiuJuan, Yuan Wei, Chen JianPing, Miao MaoHua, Olsen Jørn, Pedersen Lars Henning, Liang Hong, Li Jiong
Department of Women and Children's Health Care, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China.
Key Lab of Reproductive Regulation of NPFPC, SIPPR; IRD, Fudan University, Shanghai, China.
Pharmacoepidemiol Drug Saf. 2017 Jul;26(7):812-818. doi: 10.1002/pds.4214. Epub 2017 Apr 19.
We aimed to examine the risk of autism spectrum disorders (ASDs) in the offspring who were exposed to maternal use of β2-adrenoreceptor agonist (β2AA) during pregnancy.
This is a population-based cohort study including all live singleton births in Denmark from 1 January 1997 to 31 December 2008. Children born to mothers who used β2AA during pregnancy were categorized as exposed, and all other children were included in the unexposed group. Cases of ASDs were identified from the Danish Psychiatric Central Register and the Danish Patient Register. Incidence rate ratio (IRR) and 95% confidence interval were estimated by Poisson regression models.
Among 751 888 children in the cohort, 9098 (1.21%) received a diagnosis of ASDs. We observed an increased risk of ASDs in the exposed children (IRR = 1.28, 1.11-1.47), especially for those who were exposed during the second trimester period (IRR = 1.38, 1.14-1.67). However, when extending the exposure time window to 1 year prior to pregnancy, we observed a similar association in children born to women who received β2AA treatment during pregnancy (IRR = 1.33, 1.11-1.59) to that in children born to women who received β2AA treatment 1 year prior to pregnancy (IRR = 1.35, 1.17-1.56).
Our finding suggested that children born to women who used β2AA during pregnancy have an increased risk of ASDs in later life, which is more likely due to underlying maternal diseases rather than the exposure to β2AA itself. However, further study, which would better differentiate the effects between indication and medicine, is needed to corroborate the finding. Copyright © 2017 John Wiley & Sons, Ltd.
我们旨在研究孕期母亲使用β2肾上腺素能受体激动剂(β2AA)的后代患自闭症谱系障碍(ASD)的风险。
这是一项基于人群的队列研究,纳入了1997年1月1日至2008年12月31日丹麦所有单胎活产儿。孕期使用β2AA的母亲所生子女被归类为暴露组,所有其他儿童纳入非暴露组。ASD病例从丹麦精神病学中央登记册和丹麦患者登记册中识别。发病率比(IRR)和95%置信区间通过泊松回归模型估计。
在该队列的751888名儿童中,9098名(1.21%)被诊断为ASD。我们观察到暴露组儿童患ASD的风险增加(IRR = 1.28,1.11 - 1.47),尤其是在孕中期暴露的儿童(IRR = 1.38,1.14 - 1.67)。然而,当将暴露时间窗口延长至怀孕前1年时,我们观察到孕期接受β2AA治疗的女性所生子女(IRR = 1.33,1.11 - 1.59)与怀孕前1年接受β2AA治疗的女性所生子女(IRR = 1.35,1.17 - 1.56)患ASD的风险相似。
我们的研究结果表明,孕期使用β2AA的女性所生子女在以后的生活中患ASD的风险增加,这更可能是由于潜在的母体疾病而非β2AA本身的暴露。然而,需要进一步的研究来更好地区分适应症和药物之间的影响,以证实这一发现。版权所有© 2017约翰威立父子有限公司。