Assisted Reproductive Technologies and Risk of Autism and Other Developmental Disabilities

辅助生殖技术与自闭症和其他发育障碍的风险

基本信息

批准号：
10000188
负责人：
Peter Shawn Bearman
金额：
$ 51.28万
依托单位：
COLUMBIA UNIV NEW YORK MORNINGSIDE
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-09-10 至 2022-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10000188
关键词：
21 year old Address Adolescence Affect Area Assisted Reproductive Technology Award Benefits and Risks Biological Birth California Centers for Disease Control and Prevention (U.S.)Cerebral Palsy Characteristics Child Clinic Communities Complex Conceptions Data Data Set Database Management Systems Decision Making Development Developmental Disabilities Diagnosis Diagnostic Diffusion Early Diagnosis Elements Etiology Family Family Characteristics Fertility Fetal Growth Retardation Funding Goals Grant Health Personnel Heterogeneity Individual Infertility Intellectual functioning disability Length Link Location Mediating Mediation Medical Modeling Multiple Birth Offspring Neighborhoods Outcome Patients Pattern Phenotype Play Population Pregnancy Pregnancy Complications Premature Birth Prevalence Procedures Public Health Publishing Recommendation Registries Reporting Research Risk Risk Factors Role Sample Size Sampling Scandinavia Services Shapes Siblings Source Subgroup Symptoms Syndrome System Testing Time Variant autism spectrum disorder base cohort comparative design developmental disease disorder risk emerging adult epidemiology study follow-up large datasets maternal obesity modifiable risk obstetrical complication population based prenatal reproductive social success technology/technique

项目摘要

Project Summary This project seeks to expand on the success of an exploratory R21 grant previously awarded to establish capacity to link complex administrative data sets from three separate sources reporting births, conceptions from assisted reproductive technology (ART), and autism diagnoses in California. The goal of this research is to build and analyze the largest and most detailed dataset in existence on ART and developmental disabilities including autism, intellectual disability, and cerebral palsy, in a large and diverse state, with the ultimate aim of understanding the relationship between ART and risk of these disorders. We have successfully linked the California Birth Master Files to the CDC's National Assisted Reproductive Technology Surveillance System registry for California fertility clinics and to outcome data on autism and receipt of developmental services for the 1996 to 2007 birth cohorts, and published initial findings from this dataset. We seek next to expand the project significantly in order to assess in greater detail the relationship between ART and autism as well as other developmental disabilities. First, we propose to incorporate additional cohorts of California births and conceptions through at least 2016, and outcomes through at least 2020. This will expand the data set to more than eleven million births, about 123,000 ART births, and about 65,000 autism cases. This will also expand our follow-up period into early adulthood, an unprecedented feature in a population-based dataset this large that allows us to examine long-term developmental consequences of ART. In addition, we will include data on diagnoses of cerebral palsy and intellectual disability. Next, we will expand our analyses in several ways: 1) strengthen our preliminary findings in this much larger dataset by analyzing variation in the association among subgroups of infertility and ART procedure as well as potential mediating variables like obstetric complications and effect modifiers like maternal obesity; 2) model the long-term symptom expression of autism through adolescence, and test whether these patterns differ by conception group; 3) use sibling pairs discordant for ART conception to assess the role of confounding by family characteristics; 4) examine the association between ART and intellectual disability and cerebral palsy; and 5) assess the role that neighborhood characteristics play in the association between ART and developmental disabilities. Against the background of rapidly rising autism prevalence and the increasingly important role of ART in reproductive decision-making, this research has notable scientific and public health implications. By elucidating the long term developmental risks associated with specific treatments/subsets of ART patients, this project has the potential to make significant contributions to our understanding of the etiology of autism and other developmental disabilities, and to risk-benefit considerations for the recommendation and usage of specific procedures.

项目概要该项目旨在扩大先前授予的探索性 R21 拨款的成功，以建立能够链接来自报告出生、受孕的三个不同来源的复杂行政数据集来自加州的辅助生殖技术（ART）和自闭症诊断。这项研究的目标是建立和分析现有的关于 ART 和发育障碍的最大、最详细的数据集包括自闭症、智力障碍和脑瘫，处于一个庞大而多样化的状态，最终目标是了解 ART 与这些疾病风险之间的关系。我们已经成功链接了加州出生主文件提交给疾病预防控制中心的国家辅助生殖技术监测系统加州生育诊所登记处以及自闭症结果数据和接受发育服务 1996 年至 2007 年的出生队列，并发表了该数据集的初步研究结果。我们接下来寻求扩大为了更详细地评估 ART 与自闭症之间的关系以及其他发育障碍。首先，我们建议将更多的加州出生和概念至少持续到 2016 年，结果至少持续到 2020 年。这会将数据集扩展到更多超过 1100 万人出生，约 123,000 名 ART 出生者，约 65,000 名自闭症病例。这也将扩大我们的成年早期的随访期，这是基于人口的数据集中前所未有的特征使我们能够检查 ART 的长期发展后果。此外，我们还将包括以下数据：诊断为脑瘫和智力障碍。接下来，我们将从几个方面展开分析：1）通过分析之间关联的变化，加强了我们在这个更大的数据集中的初步发现不孕不育和 ART 手术的亚组以及产科并发症等潜在中介变量以及产妇肥胖等效应调节剂； 2）通过以下方式对自闭症的长期症状表达进行建模青春期，并测试这些模式是否因受孕组而异； 3）使用不一致的兄弟对 ART 概念用于评估家庭特征混杂的作用； 4）检查之间的关联艺术与智力障碍和脑瘫； 5）评估邻里特征所发挥的作用 ART 与发育障碍之间的关联。在自闭症迅速增加的背景下随着 ART 在生殖决策中的流行和日益重要的作用，这项研究显着的科学和公共卫生影响。通过阐明相关的长期发展风险通过针对 ART 患者的特定治疗/子集，该项目有可能做出重大贡献有助于我们了解自闭症和其他发育障碍的病因，以及风险效益对具体程序的建议和使用的考虑。