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Reproductive stoppage in autism spectrum disorder in a population of 2.5 million individuals / R. KUJA-HALKOLA in Molecular Autism, 10 (2019)
[article]
Titre : Reproductive stoppage in autism spectrum disorder in a population of 2.5 million individuals Type de document : Texte imprimé et/ou numérique Auteurs : R. KUJA-HALKOLA, Auteur ; H. LARSSON, Auteur ; S. LUNDSTRÖM, Auteur ; S. SANDIN, Auteur ; A. CHIZARIFARD, Auteur ; Sven BÖLTE, Auteur ; P. LICHTENSTEIN, Auteur ; E. FRANS, Auteur Article en page(s) : 45 p. Langues : Anglais (eng) Mots-clés : Autism Autism spectrum disorder Fecundity Reproduction Reproductive stoppage Index. décimale : PER Périodiques Résumé : Background: It has been suggested that parents of children with autism spectrum disorder (ASD) curtail their reproduction, a phenomenon known as reproductive stoppage. To investigate the presence of reproductive stoppage, we followed the reproduction in mothers of children with or without an ASD diagnosis using Swedish population-based registries. Methods: We followed all families with first child born in 1987 or later. In total 2,521,103 children, nested within 1,270,017 mothers, were included. Exposure was presence of ASD diagnosis in earlier born siblings, and outcome was considered as (1) inter-pregnancy interval and (2) number of subsequent children. Results: Analyses of inter-pregnancy intervals showed that the association differed across birth orders, with a lower rate of second children when first child had ASD diagnosis, but an increased rate of third and higher birth orders in families where a previous child had an ASD diagnosis. When all birth orders were simultaneously considered, families with a child with an ASD diagnosis were less likely to have another child (hazard ratio (HR), 0.79; 95% confidence interval [95% CI], 0.78-0.80). However, when adjusted for birth order, the association was close to null (HR, 0.97; 95% CI, 0.96-0.99), and after additional adjustments (maternal age, birth period, sex, paternal age, and maternal education), the association disappeared (HR, 1.00; 95% CI, 0.99-1.02). In analyses of subsequent children, after adjustment for covariates, families with an ASD diagnosis had 4% more subsequent children (rate ratio, 1.04; 95% CI, 1.03-1.05). Limitations: The study was undertaken in a country with largely tax-funded healthcare; results may not generalize to other societies. Following the current dominating umbrella concept of ASD, we did not differentiate between the ASD sub-diagnoses; it is possible that reproductive patterns can be dependent on ASD subtypes and the severity and composition of ASD phenotypes and comorbidities. Conclusions: This study does not support a universal reproductive stoppage effect in ASD families, when birth order and other factors are considered. Therefore, proper attention to birth order and other factors may alleviate potential bias in familial aggregation studies of ASD. En ligne : http://dx.doi.org/10.1186/s13229-019-0300-6 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=414
in Molecular Autism > 10 (2019) . - 45 p.[article] Reproductive stoppage in autism spectrum disorder in a population of 2.5 million individuals [Texte imprimé et/ou numérique] / R. KUJA-HALKOLA, Auteur ; H. LARSSON, Auteur ; S. LUNDSTRÖM, Auteur ; S. SANDIN, Auteur ; A. CHIZARIFARD, Auteur ; Sven BÖLTE, Auteur ; P. LICHTENSTEIN, Auteur ; E. FRANS, Auteur . - 45 p.
Langues : Anglais (eng)
in Molecular Autism > 10 (2019) . - 45 p.
Mots-clés : Autism Autism spectrum disorder Fecundity Reproduction Reproductive stoppage Index. décimale : PER Périodiques Résumé : Background: It has been suggested that parents of children with autism spectrum disorder (ASD) curtail their reproduction, a phenomenon known as reproductive stoppage. To investigate the presence of reproductive stoppage, we followed the reproduction in mothers of children with or without an ASD diagnosis using Swedish population-based registries. Methods: We followed all families with first child born in 1987 or later. In total 2,521,103 children, nested within 1,270,017 mothers, were included. Exposure was presence of ASD diagnosis in earlier born siblings, and outcome was considered as (1) inter-pregnancy interval and (2) number of subsequent children. Results: Analyses of inter-pregnancy intervals showed that the association differed across birth orders, with a lower rate of second children when first child had ASD diagnosis, but an increased rate of third and higher birth orders in families where a previous child had an ASD diagnosis. When all birth orders were simultaneously considered, families with a child with an ASD diagnosis were less likely to have another child (hazard ratio (HR), 0.79; 95% confidence interval [95% CI], 0.78-0.80). However, when adjusted for birth order, the association was close to null (HR, 0.97; 95% CI, 0.96-0.99), and after additional adjustments (maternal age, birth period, sex, paternal age, and maternal education), the association disappeared (HR, 1.00; 95% CI, 0.99-1.02). In analyses of subsequent children, after adjustment for covariates, families with an ASD diagnosis had 4% more subsequent children (rate ratio, 1.04; 95% CI, 1.03-1.05). Limitations: The study was undertaken in a country with largely tax-funded healthcare; results may not generalize to other societies. Following the current dominating umbrella concept of ASD, we did not differentiate between the ASD sub-diagnoses; it is possible that reproductive patterns can be dependent on ASD subtypes and the severity and composition of ASD phenotypes and comorbidities. Conclusions: This study does not support a universal reproductive stoppage effect in ASD families, when birth order and other factors are considered. Therefore, proper attention to birth order and other factors may alleviate potential bias in familial aggregation studies of ASD. En ligne : http://dx.doi.org/10.1186/s13229-019-0300-6 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=414 Selection bias induced by reproductive stoppage in estimates of recurrence risk for autism spectrum disorders / Michael BEENSTOCK in Research in Autism Spectrum Disorders, 89 (November 2021)
[article]
Titre : Selection bias induced by reproductive stoppage in estimates of recurrence risk for autism spectrum disorders Type de document : Texte imprimé et/ou numérique Auteurs : Michael BEENSTOCK, Auteur Article en page(s) : 101863 Langues : Anglais (eng) Mots-clés : Recurrence risk of ASD Reproductive stoppage Selection bias Incidental truncation method Inverse probability weighting Index. décimale : PER Périodiques Résumé : Background In observational studies it is implicitly assumed that the data are representative of the general population. Self-selection by individuals may undermine this assumption, inducing sample selection bias. In studies of recurrence risk of autism spectrum disorder (ASD) it is implicitly assumed that parents who had no further children face the same recurrence risk as parents who had further children. If this assumption is false, estimates of recurrence risk may be too high or too low. Method Two canonical statistical methods for detecting and correcting for sample selection bias, including incidental truncation and inverse probability weighting, are applied to population cohort data for Israel. The data comprise 8205 younger siblings of 9117 children diagnosed with ASD, among which there were 371 recurrences. Reproductive stoppage occurred in 4216 out of 9117 families. Participants are distinguished by demographics (gender, age), ethnicity (Jews and Arabs), religiosity, birth cohort and socioeconomic status. Results Correcting for selection bias using the incidental truncation method, the average risk of recurrence is 3.83 (95 %CI: 3.41 %–4.24 %) instead of 4.53 % (95 %CI: 4.08 %–4.98 %). The bias has p-value 0.082. Since the incidental truncation method may be sensitive to parametric assumptions regarding the joint distribution of unobserved heterogeneity in stoppage and recurrence risk, robustness tests are carried out using alternative parametric assumptions, including copulas. Results using the method of inverse probability weighting were unsatisfactory because they were sensitive to hidden confounders. Conclusions Studies of recurrent risk of ASD should take account of potential selection bias induced by reproductive stoppage. En ligne : https://doi.org/10.1016/j.rasd.2021.101863 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=458
in Research in Autism Spectrum Disorders > 89 (November 2021) . - 101863[article] Selection bias induced by reproductive stoppage in estimates of recurrence risk for autism spectrum disorders [Texte imprimé et/ou numérique] / Michael BEENSTOCK, Auteur . - 101863.
Langues : Anglais (eng)
in Research in Autism Spectrum Disorders > 89 (November 2021) . - 101863
Mots-clés : Recurrence risk of ASD Reproductive stoppage Selection bias Incidental truncation method Inverse probability weighting Index. décimale : PER Périodiques Résumé : Background In observational studies it is implicitly assumed that the data are representative of the general population. Self-selection by individuals may undermine this assumption, inducing sample selection bias. In studies of recurrence risk of autism spectrum disorder (ASD) it is implicitly assumed that parents who had no further children face the same recurrence risk as parents who had further children. If this assumption is false, estimates of recurrence risk may be too high or too low. Method Two canonical statistical methods for detecting and correcting for sample selection bias, including incidental truncation and inverse probability weighting, are applied to population cohort data for Israel. The data comprise 8205 younger siblings of 9117 children diagnosed with ASD, among which there were 371 recurrences. Reproductive stoppage occurred in 4216 out of 9117 families. Participants are distinguished by demographics (gender, age), ethnicity (Jews and Arabs), religiosity, birth cohort and socioeconomic status. Results Correcting for selection bias using the incidental truncation method, the average risk of recurrence is 3.83 (95 %CI: 3.41 %–4.24 %) instead of 4.53 % (95 %CI: 4.08 %–4.98 %). The bias has p-value 0.082. Since the incidental truncation method may be sensitive to parametric assumptions regarding the joint distribution of unobserved heterogeneity in stoppage and recurrence risk, robustness tests are carried out using alternative parametric assumptions, including copulas. Results using the method of inverse probability weighting were unsatisfactory because they were sensitive to hidden confounders. Conclusions Studies of recurrent risk of ASD should take account of potential selection bias induced by reproductive stoppage. En ligne : https://doi.org/10.1016/j.rasd.2021.101863 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=458