| Summary: | 碩士 === 國立陽明大學 === 公共衛生研究所 === 103 === Objectives: Evidence from animal models has implicated potential roles of disordered immunological responses in etiological and pathological processes underlying childhood-onset neurodevelopmental disorders. Clinical studies observed that atopic disorders usually emerged in the first years of life in the form of atopic dermatitis (AD) and later evolved into respiratory atopic disorders (e.g., asthma). The present study assessed the relationship between allergic condition in early life with the incidence of ASD and ADHD through childhood.
Methods: We conducted a population-based longitudinal cohort study comprising children enrolled in the National Health Insurance Program during 2000-2010 in Taiwan. A total of 387,262 (30.7%) AD-exposed children born during 2000-2004 (i.e., receiving the initial AD diagnosis before age of 2) were first identified, with 1:1 individual matching on birth year, birth season, and residential region for unexposed children. Cox regression analyses were performed to estimate time-varying risk of early-onset and accumulative effects of allergic disorders with ASD and ADHD.
Results: An estimated 0.5% and 3.7% atopic dermatitis-exposed children accordingly received the diagnosis of ASD and ADHD, significantly higher than 0.4% and 2.9% in comparison children. With simultaneous adjustment for individual sociodemographic characteristics, having atopic dermatitis before age 2 may increase the hazard of ASD by 11% (95% CI: 1.03, 1.18) and 16% for ADHD (95% CI: 1.13, 1.19). The increased hazards were also manifested in respiratory atopic diseases occurring during toddlerhood and childhood (e.g., ASD, aHR=1.26 and 1.54, p<0.001).
Conclusions: The observed increased risks of ASD and ADHD associated with atopic condition in infancy and childhood may suggest the disordered immunological response may exert effects beyond infancy (e.g., the critical exposure window) and provide some implication for etiology research and treatment strategy.
Key words: Autism Spectrum Disorder (ASD); Attention Deficit/Hyperactivity Disorder (ADHD); atopic dermatitis (AD); time-dependent; atopic march
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