Autism and antibiotic exposure in infancy are not related

  • Hamad AF & al.
  • Int J Epidemiol
  • 7 Aug 2018

  • curated by Emily Willingham, PhD
  • Clinical Essentials
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Takeaway

  • Antibiotic exposure in the first year of life is not associated with autism risk.
  • Researchers say that the findings should help clinicians reassure parents.

Why this matters

  • Some hypotheses have posited microbiota as related to autism etiology.

Key results

  • 43.8% had filled antibiotic prescription.
  • 2965 of the total cohort were diagnosed with autism.
  • Adjusted HR (aHR) for autism with antibiotics use was 0.91 (95% CI, 0.84-0.99).
  • No link was found with number of courses of antibiotics or cumulative exposures.
  • Subset analyses showed some association for boys (aHR, 0.91; 95% CI, 0.83-1.00) and residents of urban areas (aHR, 0.85; 95% CI, 0.77-0.94).
  • There was no association in sibling-controlled analysis. 

Study design

  • Population-based cohort study, Manitoba, Canada; administrative health data, all live births (n=214,834) from April 1, 1998, to March 31, 2016.
  • Exposure: antibiotic prescription.
  • Outcome: autism diagnosis.
  • Funding: University of Manitoba; Evelyn Shapiro Award for Health Services Research.

Limitations

  • Filled prescription does not always mean the drugs were used.
  • Some other exposure time window might be more relevant.
  • Residual confounding is possible.

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