Association Between Antenatal Antimicrobial Therapy and Autism Spectrum Disorder—A Nested Case-Control Study

Background: Multiple prenatal factors have been associated with autism spectrum disorder (ASD) risk. However, current data about the association between antimicrobial use during pregnancy and ASD is limited.Methods: A nested matched case-control study of children with ASD (cases), and children witho...

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Autores principales:	Nitzan Abelson, Gal Meiri, Shirley Solomon, Hagit Flusser, Analya Michaelovski, Ilan Dinstein, Idan Menashe
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	Autism spectrum disorder (ASD) prenatal antimicrobial drugs public health ethnic disparities Psychiatry RC435-571
Acceso en línea:	https://doaj.org/article/7ef87d59b8994ca0abc4b2883b7e9d9c
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spelling	oai:doaj.org-article:7ef87d59b8994ca0abc4b2883b7e9d9c2021-11-19T04:46:15ZAssociation Between Antenatal Antimicrobial Therapy and Autism Spectrum Disorder—A Nested Case-Control Study1664-064010.3389/fpsyt.2021.771232https://doaj.org/article/7ef87d59b8994ca0abc4b2883b7e9d9c2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fpsyt.2021.771232/fullhttps://doaj.org/toc/1664-0640Background: Multiple prenatal factors have been associated with autism spectrum disorder (ASD) risk. However, current data about the association between antimicrobial use during pregnancy and ASD is limited.Methods: A nested matched case-control study of children with ASD (cases), and children without ASD or other psychiatric or genetic disorders (controls). We compared the use of antimicrobial therapy during the 3 months before conception or during pregnancy between mothers of cases and controls and used multivariate conditional logistic regression models to assess the independent association between maternal use of antimicrobials during pregnancy and the risk of ASD in their offspring.Results: More than half of the mothers in the study (54.1%) used antimicrobial drugs during the 3 months before conception or during pregnancy. Rates of antimicrobial use were lower for mothers of children with ASD compared to mothers of controls (49.0 vs. 55.1%, respectively; p = 0.02), especially during the third trimester of pregnancy (18.8 vs. 22.9%, respectively; p = 0.03), and for the use of penicillins (15.7 vs. 19.7%, respectively; p = 0.06). These case–control differences suggest that antimicrobial administration during pregnancy was associated with a reduced risk of ASD in the offspring (aOR = 0.75, 95% CI = 0.61–0.92). Interestingly, this association was seen only among Jewish but not for the Bedouin mothers (aOR = 0.62, 95% CI = 0.48–0.79 and aOR = 1.21, 95% CI = 0.82–1.79).Conclusions: The reduced risk of ASD associated with prenatal antimicrobials use only in the Jewish population suggest the involvement of other ethnic differences in healthcare services utilization in this association.Nitzan AbelsonGal MeiriGal MeiriShirley SolomonHagit FlusserHagit FlusserAnalya MichaelovskiAnalya MichaelovskiIlan DinsteinIlan DinsteinIlan DinsteinIdan MenasheIdan MenasheIdan MenasheFrontiers Media S.A.articleAutism spectrum disorder (ASD)prenatalantimicrobial drugspublic healthethnic disparitiesPsychiatryRC435-571ENFrontiers in Psychiatry, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Autism spectrum disorder (ASD) prenatal antimicrobial drugs public health ethnic disparities Psychiatry RC435-571
spellingShingle	Autism spectrum disorder (ASD) prenatal antimicrobial drugs public health ethnic disparities Psychiatry RC435-571 Nitzan Abelson Gal Meiri Gal Meiri Shirley Solomon Hagit Flusser Hagit Flusser Analya Michaelovski Analya Michaelovski Ilan Dinstein Ilan Dinstein Ilan Dinstein Idan Menashe Idan Menashe Idan Menashe Association Between Antenatal Antimicrobial Therapy and Autism Spectrum Disorder—A Nested Case-Control Study
description	Background: Multiple prenatal factors have been associated with autism spectrum disorder (ASD) risk. However, current data about the association between antimicrobial use during pregnancy and ASD is limited.Methods: A nested matched case-control study of children with ASD (cases), and children without ASD or other psychiatric or genetic disorders (controls). We compared the use of antimicrobial therapy during the 3 months before conception or during pregnancy between mothers of cases and controls and used multivariate conditional logistic regression models to assess the independent association between maternal use of antimicrobials during pregnancy and the risk of ASD in their offspring.Results: More than half of the mothers in the study (54.1%) used antimicrobial drugs during the 3 months before conception or during pregnancy. Rates of antimicrobial use were lower for mothers of children with ASD compared to mothers of controls (49.0 vs. 55.1%, respectively; p = 0.02), especially during the third trimester of pregnancy (18.8 vs. 22.9%, respectively; p = 0.03), and for the use of penicillins (15.7 vs. 19.7%, respectively; p = 0.06). These case–control differences suggest that antimicrobial administration during pregnancy was associated with a reduced risk of ASD in the offspring (aOR = 0.75, 95% CI = 0.61–0.92). Interestingly, this association was seen only among Jewish but not for the Bedouin mothers (aOR = 0.62, 95% CI = 0.48–0.79 and aOR = 1.21, 95% CI = 0.82–1.79).Conclusions: The reduced risk of ASD associated with prenatal antimicrobials use only in the Jewish population suggest the involvement of other ethnic differences in healthcare services utilization in this association.
format	article
author	Nitzan Abelson Gal Meiri Gal Meiri Shirley Solomon Hagit Flusser Hagit Flusser Analya Michaelovski Analya Michaelovski Ilan Dinstein Ilan Dinstein Ilan Dinstein Idan Menashe Idan Menashe Idan Menashe
author_facet	Nitzan Abelson Gal Meiri Gal Meiri Shirley Solomon Hagit Flusser Hagit Flusser Analya Michaelovski Analya Michaelovski Ilan Dinstein Ilan Dinstein Ilan Dinstein Idan Menashe Idan Menashe Idan Menashe
author_sort	Nitzan Abelson
title	Association Between Antenatal Antimicrobial Therapy and Autism Spectrum Disorder—A Nested Case-Control Study
title_short	Association Between Antenatal Antimicrobial Therapy and Autism Spectrum Disorder—A Nested Case-Control Study
title_full	Association Between Antenatal Antimicrobial Therapy and Autism Spectrum Disorder—A Nested Case-Control Study
title_fullStr	Association Between Antenatal Antimicrobial Therapy and Autism Spectrum Disorder—A Nested Case-Control Study
title_full_unstemmed	Association Between Antenatal Antimicrobial Therapy and Autism Spectrum Disorder—A Nested Case-Control Study
title_sort	association between antenatal antimicrobial therapy and autism spectrum disorder—a nested case-control study
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/7ef87d59b8994ca0abc4b2883b7e9d9c
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Association Between Antenatal Antimicrobial Therapy and Autism Spectrum Disorder—A Nested Case-Control Study

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