怀孕期间使用血清增强抗抑郁药与儿童自闭症谱系障碍之间的关联
Hilary K Brown1, Joel G Ray2, Andrew S Wilton3
1Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada2Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada3Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
JAMA
|April 19, 2017
概括
这项研究没有发现产前暴露于血清抗抑郁药和儿童自闭症谱系障碍之间有显著的关联. 之前的观察可以通过混因素来解释,而不是直接的因果关系.
科学领域:
- 神经科学
- 儿童发育医学
- 药物流行病学
背景情况:
- 之前的研究表明,孕妇在怀孕期间使用抗抑郁药物与儿童患自闭症谱系障碍 (ASD) 的风险增加之间存在潜在联系.
- 然而,这些关联可能受到混因素的影响,需要进一步调查.
研究的目的:
- 调查子宫内暴露于血清抗抑郁药物与儿童随后诊断出自闭症谱系障碍之间的关联.
- 通过先进的统计方法解决潜在的混因素.
主要方法:
- 一项回顾性队列研究,利用加拿大安大略省的卫生行政数据 (2002-2010).
- 通过处方记录确定了母亲对选择性血清素再吸收抑制剂 (SSRI) 或血清素- 上腺素再吸收抑制剂 (SNRIs) 的暴露.
- 针对自闭症的诊断,对儿童进行了长达2年的跟踪,并使用治疗权重和兄弟姐妹比较的逆概率进行了调整.
主要成果:
- 这项研究包括35,906名单子产妇,其中7. 9%的孕妇在怀孕期间服用了抗抑郁药.
- 初步分析显示暴露儿童的自闭症发病率较高,但在使用高维度倾向得分进行调整后,这种关联并不显著.
- 与未暴露的兄弟姐妹进行比较也显示出不显著的关联.
结论:
- 在安大略省,有公共药物覆盖范围的母亲产生的婴儿中,接受血清抗抑郁药物的暴露与自闭症谱系障碍的风险增加无关.
- 之前观察到的关联可能是由于未测量的混因素而不是直接的因果关系.
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