Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.
Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.
Autism Res. 2022 Apr;15(4):740-750. doi: 10.1002/aur.2680. Epub 2022 Feb 2.
Reports on the association between the prevalence of atopic diseases and neurodevelopmental disabilities (NDs) have been inconsistent in the literature. We investigated whether autism spectrum disorder (ASD), attention deficit-hyperactivity disorders (ADHD), and other NDs are more prevalent in children with asthma, atopic dermatitis (AD) and allergic rhinitis (AR) compared to those without specific atopic conditions. A total of 2580 children enrolled at birth were followed prospectively, of which 119 have ASD, 423 have ADHD, 765 have other NDs, and 1273 have no NDs. Atopic diseases and NDs were defined based on physician diagnoses in electronic medical records. Logistic regressions adjusting for maternal and child characteristics estimated the associations between NDs (i.e., ASD, ADHD, and other NDs) and asthma, AD and AR, respectively. Children with asthma, AD or AR had a greater likelihood of having ADHD or other NDs compared with children without specific atopic conditions. The association between ASD and asthma diminished after adjusting for maternal and child factors. Either mothers or children having atopic conditions and both mothers and children with atopic conditions were associated with a higher prevalence of ADHD in children, compared with neither mothers nor children having atopic conditions. Children diagnosed with multiple atopic diseases were more likely to have NDs compared with those without or with only one type of atopic disease. In conclusion, in this U.S. urban birth cohort, children with atopic diseases had a higher co-morbidity of NDs. The findings have implications for etiologic research that searches for common early life antecedents of NDs and atopic conditions. Findings from this study also should raise awareness among health care providers and parents about the possible co-occurrence of both NDs and atopic conditions, which calls for coordinated efforts to screen, prevent and manage NDs and atopic conditions.
关于特应性疾病和神经发育障碍（NDs）的患病率之间的关联，文献中的报道并不一致。我们调查了哮喘、特应性皮炎（AD）和过敏性鼻炎（AR）患儿与无特应性疾病患儿相比，自闭症谱系障碍（ASD）、注意力缺陷多动障碍（ADHD）和其他 NDs 是否更为常见。共有 2580 名儿童在出生时入组并进行前瞻性随访，其中 119 例患有 ASD，423 例患有 ADHD，765 例患有其他 NDs，1273 例无 NDs。特应性疾病和 NDs 根据电子病历中的医生诊断来定义。通过调整母婴特征的逻辑回归来估计 NDs（即 ASD、ADHD 和其他 NDs）与哮喘、AD 和 AR 之间的关联。与无特定特应性疾病的儿童相比，患有哮喘、AD 或 AR 的儿童更有可能患有 ADHD 或其他 NDs。在调整了母婴因素后，ASD 与哮喘之间的关联减弱。无论母亲还是儿童患有特应性疾病，或者母亲和儿童都患有特应性疾病，与既无母亲也无儿童患有特应性疾病的儿童相比，ADHD 的患病率更高。与无特应性疾病或仅有一种特应性疾病的儿童相比，被诊断为多种特应性疾病的儿童更有可能患有 NDs。总之，在这项美国城市出生队列研究中，患有特应性疾病的儿童 NDs 的共病率更高。这些发现对病因研究具有重要意义，病因研究旨在寻找 NDs 和特应性疾病的共同早期生活诱因。本研究的结果还应引起医疗保健提供者和家长的注意，即可能同时发生 NDs 和特应性疾病，这需要协调努力来筛查、预防和管理 NDs 和特应性疾病。
