抗生素的使用和自闭症谱系障碍和注意力缺陷/多动障碍的风险:基于人口的队列研究
Kai-Lin Yang1, Ting-An Yen2, Fang-Ju Lin1,3,4
1Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.
Child and adolescent psychiatry and mental health
|July 11, 2024
概括
儿童早期抗生素暴露对自闭症谱系障碍 (ASD) 和注意力缺陷/多动症障碍 (ADHD) 风险的影响很小. 这些发现表明,及时使用抗生素是适当的,即使对神经发育结果存在担忧.
科学领域:
- 神经科学是一个神经科学.
- 儿科 儿科 儿科
- 药理学 药理学是指药理学的学科.
背景情况:
- 肠-大脑轴表明肠道微生物群和神经发育之间存在联系.
- 之前关于早期抗生素暴露和自闭症谱系障碍 (ASD) 或注意力缺陷/多动症障碍 (ADHD) 风险的研究已经产生了不一致的结果.
研究的目的:
- 调查假设,在生命的前两年暴露在抗菌剂增加了ASD和/或ADHD的风险.
主要方法:
- 使用台湾国家健康保险研究数据库 (2003-2019) 进行的回顾性队列研究.
- 包括单独的,完全的兄弟姐妹和暴露不一致的兄弟姐妹对队伍.
- 分析了0-2岁之间至少有一次抗菌处方的儿童,并在15岁时被诊断出ASD/ADHD,并根据使用Cox比例危险模型的混因素进行调整.
主要成果:
- 抗生素暴露在单独 (aHR: 1.06) 和完全兄弟姐妹 (aHR: 1.03) 队列中显示出ASD/ADHD风险的边际增加.
- 在暴露不一致的兄弟对队列中观察到风险略有降低 (aHR:0.92).
- 这项研究仅分析了单个队列中的94.6万多名儿童.
结论:
- 早期的抗生素暴露似乎对ASD和/或ADHD的风险的影响很小.
- 鉴于边际和接近零的估计影响,担忧不应该阻止及时和适当的抗生素使用.
- 进一步的研究可能会探索特定的抗生素类别或暴露时间内的细微影响.
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