Assisted Reproductive Technologies and Increased Autism Risk

辅助生殖技术和自闭症风险增加

• 批准号: 8301348
• 负责人: Peter Shawn Bearman
• 金额: $ 20万
• 依托单位: COLUMBIA UNIV NEW YORK MORNINGSIDE
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-04-15 至 2014-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8301348
• 关键词: Accounting; Age; Algorithms; Assisted Reproductive Technology; Autistic Disorder; Behavior; Benefits and Risks; Biological; Birth; California; Centers for Disease Control and Prevention (U.S.); Characteristics; Child; Clinic; Code; Data; Data Set; Decision Making; Development; Diagnostic; Embryo; Etiology; Family Characteristics; Fertility; Fertilization in Vitro; General Population; Goals; Health Personnel; Individual; Infertility; Life Cycle Stages; Link; Methods; Other Genetics; Outcome; Parental Ages; Parents; Pathway interactions; Persons; Play; Population; Population Characteristics; Prevalence; Procedures; Protocols documentation; Public Health; Registries; Relative Risks; Reporting; Research; Risk; Risk Factors; Role; Sample Size; Sampling; Security; Services; Siblings; Source; System; Time; Twin Multiple Birth; Work; design; egg; high risk; modifiable risk; reproductive; residence

DESCRIPTION (provided by applicant): This project will link an existing population level dataset consisting of all California births between 1996 and 2006 (over five million children, over 60,000 twin pairs, and over 1 million full and half sibling groups) and outcome data on autism and receipt of developmental services to the CDC's National Assisted Reproductive Technology Surveillance System registry for California infertility clinics for the same period. We will use ths detailed dataset from a large ethnically and geographically diverse state to assess the relationship, if any, between Assisted Reproductive Technology (ART), including in vitro fertilization and related procedures, and autism and to identify the pathways through which this association operates. ART and autism have both increased rapidly in recent decades, and although a relationship is widely suspected, existing research has reported mixed and inconclusive findings, largely a result of insufficient samples. Our design, which enables us to identify about 50,000 ART births and about 24,000 cases of autistic disorder over ten consecutive years, overcomes previous limitations and promises to enable an accurate estimation of autism risk associated with ART. Further, the detailed information we will have on child, parent and family characteristics, residence at birth, ART methods and procedures, and autism outcomes will allow us to better understand the mechanisms at play. With this information, we can 1) identify whether such an association is confounded by individual characteristics selective for both autism and ART, such as parental age, SES, and infertility factors; 2) identify whether an observed association between ART and autism is uniform across ART protocols or is specific to certain method(s); 3) explore the role of clinic-level factors; and 4) ascertain the temporal and spatial correlates of the association of ART and autism. Against the background of rapidly rising autism prevalence and the increasingly important role of ART in reproductive decision-making, this research has important scientific and public health implications. This project has the potential to make significant contributions to our understanding of the etiology of autism as well as the long-term outcomes of ART births, neither of which are well understood. PUBLIC HEALTH RELEVANCE: The prevalence of autism has increased rapidly over the last three decades, although its causes remain poorly understood; meanwhile the use of Assisted Reproductive Technology (ART) has also increased dramatically, although the long-term risks to children conceived this way remain largely unknown. This project will contribute to public health by creating a unique population- level dataset designed to ascertain any potential association between ART or its subtypes and autism as well as identify the mechanisms of the association. This will better enable individuals and their health care providers to weigh the risks and benefits of ART procedures and to recognize a potentially modifiable risk factor for autism.

描述（由申请人提供）：该项目将链接现有的人口水平数据集，其中包括 1996 年至 2006 年间所有加利福尼亚州的出生人口（超过 500 万儿童，超过 60,000对双胞胎，以及超过100万个全兄弟姐妹和同父异母兄弟姐妹群体）以及自闭症结果数据和同期加州不孕不育诊所的CDC国家辅助生殖技术监测系统登记处接受发育服务的数据。我们将使用来自一个种族和地理多样化的大州的详细数据集来评估辅助生殖技术（ART）（包括体外受精和相关程序）与自闭症之间的关系（如果有的话），并确定该协会运作的途径。近几十年来，ART 和自闭症都迅速增加，尽管人们普遍怀疑两者之间存在关系，但现有研究报告的结果好坏参半且不确定，这主要是样本不足的结果。我们的设计使我们能够在连续十年内识别出约 50,000 名 ART 新生儿和约 24,000 例自闭症病例，克服了之前的限制，并有望准确估计与 ART 相关的自闭症风险。此外，我们将获得有关儿童、父母和家庭特征、出生时居住地、ART 方法和程序以及自闭症结果的详细信息，这将使我们能够更好地了解其中的机制。有了这些信息，我们可以 1) 确定这种关联是否受到对自闭症和 ART 选择性的个人特征的混淆，例如父母年龄、SES 和不孕因素； 2) 确定观察到的 ART 与自闭症之间的关联是否在 ART 方案中是一致的，还是特定于某些方法； 3）探索临床层面因素的作用；和 4）确定ART与自闭症关联的时间和空间相关性。在自闭症患病率迅速上升以及辅助生殖技术在生殖决策中日益重要的作用的背景下，这项研究具有重要的科学和公共卫生意义。该项目有潜力为我们的理解做出重大贡献 自闭症的病因学以及 ART 分娩的长期结果，这两者都尚不清楚。 公共卫生相关性：过去三十年来，自闭症的患病率迅速增加，尽管其原因仍知之甚少；与此同时，辅助生殖技术（ART）的使用也急剧增加，尽管这种方式怀孕的孩子的长期风险仍然很大程度上未知。该项目将通过创建一个独特的人口水平数据集来为公共卫生做出贡献，该数据集旨在确定 ART 或其亚型与自闭症之间的任何潜在关联，并确定该关联的机制。这将使个人及其医疗保健提供者更好地权衡风险和收益 ART 程序并认识到自闭症的潜在可改变风险因素。