Obstetric oxytocin exposure and ADHD and ASD among Danish and Finnish children.

Attention Deficit Disorder with Hyperactivity / chemically induced Autism Spectrum Disorder / chemically induced Child Denmark / epidemiology Female Finland / epidemiology Humans Male Oxytocin / adverse effects Pregnancy
Attention deficit hyperactivity deficits autism spectrum disorder cross-national oxytocin

Journal

International journal of epidemiology
ISSN: 1464-3685
Titre abrégé: Int J Epidemiol
Pays: England
ID NLM: 7802871

Informations de publication

Date de publication:
17 05 2021
Historique:
accepted: 06 04 2020
pubmed: 15 6 2020
medline: 8 7 2021
entrez: 15 6 2020
Statut: ppublish

Résumé

Some studies have indicated an increased risk of attention deficit hyperactivity disorder (ADHD) and a small, sex-specific association with autism spectrum disorder (ASD) among children prenatally exposed to obstetric oxytocin. Since oxytocin is widely used in the obstetric ward, these potentially deleterious effects are of concern. Thus, we aimed to examine whether obstetric oxytocin treatment for labour induction or augmentation is associated with ADHD and ASD in offspring born in a two-country design based on data from Denmark and Finland. This population-based study used data from national registers in Denmark and Finland. Singletons born in Denmark 2000-10 (n = 577 380) and Finland 1991-2010 (n = 945 543), who survived infancy, were followed until 31 December 2015. ADHD and ASD were defined using diagnostic codes. For ADHD, we also included information on prescribed and redeemed ADHD medication in the definition. Hazards ratios (HRs) with 95% confidence intervals (CI), modelled with age as the underlying time scale, were calculated to estimate the associations. Oxytocin was used in 31% and 46% of the included deliveries in Denmark and Finland, respectively. In crude analyses, prenatal oxytocin was associated with an approximately 20% increased risk of ADHD and ASD, but confounder adjustment attenuated the association. The adjusted HR was 1.03, 95% CI 1.01-1.05, for ADHD and 1.05, 95% CI 1.02-1.08, for ASD. The results were similar in across country and gender. We found an association between synthetic oxytocin and ADHD or ASD which is unlikely to reflect a causal association and thus should not support the concern of clinical use. Our results help to allay concerns of obstetric use of oxytocin causing ADHD or ASD.

Sections du résumé

BACKGROUND
Some studies have indicated an increased risk of attention deficit hyperactivity disorder (ADHD) and a small, sex-specific association with autism spectrum disorder (ASD) among children prenatally exposed to obstetric oxytocin. Since oxytocin is widely used in the obstetric ward, these potentially deleterious effects are of concern. Thus, we aimed to examine whether obstetric oxytocin treatment for labour induction or augmentation is associated with ADHD and ASD in offspring born in a two-country design based on data from Denmark and Finland.
METHODS
This population-based study used data from national registers in Denmark and Finland. Singletons born in Denmark 2000-10 (n = 577 380) and Finland 1991-2010 (n = 945 543), who survived infancy, were followed until 31 December 2015. ADHD and ASD were defined using diagnostic codes. For ADHD, we also included information on prescribed and redeemed ADHD medication in the definition. Hazards ratios (HRs) with 95% confidence intervals (CI), modelled with age as the underlying time scale, were calculated to estimate the associations.
RESULTS
Oxytocin was used in 31% and 46% of the included deliveries in Denmark and Finland, respectively. In crude analyses, prenatal oxytocin was associated with an approximately 20% increased risk of ADHD and ASD, but confounder adjustment attenuated the association. The adjusted HR was 1.03, 95% CI 1.01-1.05, for ADHD and 1.05, 95% CI 1.02-1.08, for ASD. The results were similar in across country and gender.
CONCLUSIONS
We found an association between synthetic oxytocin and ADHD or ASD which is unlikely to reflect a causal association and thus should not support the concern of clinical use. Our results help to allay concerns of obstetric use of oxytocin causing ADHD or ASD.

Identifiants

DOI: 10.1093/ije/dyaa076 PMID: 32535618
pubmed: 32535618
pii: 5857280
doi: 10.1093/ije/dyaa076
doi:

Substances chimiques

Oxytocin 50-56-6

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

446-456

Commentaires et corrections

Type : CommentIn

Informations de copyright

© The Author(s) 2020; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

Auteurs

Lonny Stokholm (L)

Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
ORCID: 0000-0002-9727-6649

Mette Juhl (M)

Department of Midwifery, Copenhagen University College, Copenhagen, Denmark.

Nicole M Talge (NM)

Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA.

Mika Gissler (M)

Department of Information Services, THL Finnish Institute for Health and Welfare, Helsinki, Finland.
Research Centre for Child Psychiatry, University of Turku, Turku, Finland.
Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.

Carsten Obel (C)

Section for General Medical Practice, Department of Public Health, Aarhus University, Aarhus, Denmark.

Katrine Strandberg-Larsen (K)

Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.

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Classifications MeSH

questionsmedicales.fr › Troubles mentaux › Troubles du développement neurologique › Troubles déficitaires de l'attention et du comportement perturbateur › Trouble déficitaire de l'attention avec hyperactivité › Obstetric oxytocin exposure and ADHD and ASD...
questionsmedicales.fr › Troubles mentaux › Troubles du développement neurologique › Troubles généralisés du développement de l'enfant › Trouble du spectre autistique › Obstetric oxytocin exposure and ADHD and ASD...
questionsmedicales.fr › Personnes › Tranches d'âge › Enfant › Obstetric oxytocin exposure and ADHD and ASD...
questionsmedicales.fr › Régions géographiques › Europe › Pays nordiques et scandinaves › Danemark › Obstetric oxytocin exposure and ADHD and ASD...
questionsmedicales.fr › Régions géographiques › Europe › Pays nordiques et scandinaves › Finlande › Obstetric oxytocin exposure and ADHD and ASD...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Obstetric oxytocin exposure and ADHD and ASD...
questionsmedicales.fr › Acides aminés, peptides et protéines › Peptides › Hormones peptidiques › Hormones hypophysaires › Hormones post-hypophysaires › Ocytocine › Obstetric oxytocin exposure and ADHD and ASD...
questionsmedicales.fr › Phénomènes physiologiques des appareils urinaire et reproducteur › Phénomènes physiologiques de la reproduction › Reproduction › Grossesse › Obstetric oxytocin exposure and ADHD and ASD...