Department of Pediatrics, Developmental Section, University of Colorado School of Medicine, 13123 E. 16th Ave. B065, Aurora, CO, 80045, USA.
Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
J Neurodev Disord. 2024 May 26;16(1):26. doi: 10.1186/s11689-024-09540-1.
Synthetic oxytocin (sOT) is frequently administered during parturition. Studies have raised concerns that fetal exposure to sOT may be associated with altered brain development and risk of neurodevelopmental disorders. In a large and diverse sample of children with data about intrapartum sOT exposure and subsequent diagnoses of two prevalent neurodevelopmental disorders, i.e., attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), we tested the following hypotheses: (1) Intrapartum sOT exposure is associated with increased odds of child ADHD or ASD; (2) associations differ across sex; (3) associations between intrapartum sOT exposure and ADHD or ASD are accentuated in offspring of mothers with pre-pregnancy obesity.
The study sample comprised 12,503 participants from 44 cohort sites included in the Environmental Influences on Child Health Outcomes (ECHO) consortium. Mixed-effects logistic regression analyses were used to estimate the association between intrapartum sOT exposure and offspring ADHD or ASD (in separate models). Maternal obesity (pre-pregnancy BMI ≥ 30 kg/m) and child sex were evaluated for effect modification.
Intrapartum sOT exposure was present in 48% of participants. sOT exposure was not associated with increased odds of ASD (adjusted odds ratio [aOR] 0.86; 95% confidence interval [CI], 0.71-1.03) or ADHD (aOR 0.89; 95% CI, 0.76-1.04). Associations did not differ by child sex. Among mothers with pre-pregnancy obesity, sOT exposure was associated with lower odds of offspring ADHD (aOR 0.72; 95% CI, 0.55-0.96). No association was found among mothers without obesity (aOR 0.97; 95% CI, 0.80-1.18).
In a large, diverse sample, we found no evidence of an association between intrapartum exposure to sOT and odds of ADHD or ASD in either male or female offspring. Contrary to our hypothesis, among mothers with pre-pregnancy obesity, sOT exposure was associated with lower odds of child ADHD diagnosis.
合成催产素（sOT）在分娩过程中经常被使用。有研究表明，胎儿接触 sOT 可能与大脑发育改变和神经发育障碍的风险有关。在一个大型的、多样化的儿童样本中，这些儿童的数据包括分娩期间 sOT 暴露情况以及随后诊断出的两种常见神经发育障碍，即注意缺陷多动障碍（ADHD）和自闭症谱系障碍（ASD），我们检验了以下假设：（1）分娩期间 sOT 暴露与儿童 ADHD 或 ASD 的患病风险增加有关；（2）这种关联在性别间存在差异；（3）在患有孕前肥胖症的母亲的后代中，分娩期间 sOT 暴露与 ADHD 或 ASD 之间的关联更为明显。
研究样本包括来自环境影响儿童健康结局（ECHO）联盟的 44 个队列地点的 12503 名参与者。使用混合效应逻辑回归分析来估计分娩期间 sOT 暴露与后代 ADHD 或 ASD 之间的关联（分别在模型中进行分析）。评估了母体肥胖症（孕前 BMI≥30kg/m2）和儿童性别对效应修饰的作用。
48%的参与者在分娩期间接受了 sOT 治疗。sOT 暴露与 ASD 患病风险增加无关（调整后的优势比[aOR]0.86；95%置信区间[CI]，0.71-1.03）或 ADHD（aOR 0.89；95%CI，0.76-1.04）。这种关联在性别间没有差异。在患有孕前肥胖症的母亲中，sOT 暴露与后代 ADHD 患病风险降低有关（aOR 0.72；95%CI，0.55-0.96）。在没有肥胖症的母亲中，没有发现关联（aOR 0.97；95%CI，0.80-1.18）。
在一个大型的、多样化的样本中，我们没有发现分娩期间接触 sOT 与 ADHD 或 ASD 患病风险之间存在关联的证据，无论男性或女性后代均如此。与我们的假设相反，在患有孕前肥胖症的母亲中，sOT 暴露与儿童 ADHD 诊断的风险降低有关。
