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Canadian Journal of Public Health

, Volume 106, Issue 2, pp e36–e42 | Cite as

The association between the interpregnancy interval and autism spectrum disorder in a Canadian cohort

  • Helen CooEmail author
  • Hélène Ouellette-Kuntz
  • Yuk-Miu Lam
  • Marni Brownell
  • Michael P. Flavin
  • Leslie L. Roos
Quantitative Research
  • 2 Downloads

Abstract

Objectives

Two studies reported an increased risk of autistic disorder in children conceived less than 12 months after a previous birth. Our objective was to examine the association between the interpregnancy interval (IPI) and autism spectrum disorder (ASD) in a Canadian cohort.

Methods

Using administrative datasets housed at the Manitoba Centre for Health Policy, we identified pairs of first- and second-born singleton siblings born between 1988 and 2005. Diagnoses of ASD were ascertained by searching physician billing claims, hospital discharge abstracts, education data, and a database containing information on individuals identified for a 2002–2007 ASD surveillance program in Manitoba. Logistic regression models were fit to examine the association between the IPI and ASD in 41,050 second-born siblings where the first-borns did not have ASD, using IPIs of ≥36 months as the reference category and specifying three case groups. Case Group 1 included individuals with at least one ASD code (n = 490); Case Group 2 included those with two or more ASD codes (n = 375); and Case Group 3 comprised individuals with a record in the ASD surveillance program database (n = 141).

Results

The adjusted odds ratios (ORs) for IPIs shorter than 12 months ranged from 1.22 (95% CI: 0.91–1.63) for Case Group 1 to 1.72 (95% CI: 0.96–3.06) for Case Group 3. When the case groups were restricted to individuals with more severe ASD, the ORs increased and were significant for Case Groups 1 and 2.

Conclusion

Our findings also support an association between short IPIs and more severe ASD.

Key Words

Autism interpregnancy interval secondary analysis administrative data record linkage Manitoba Centre for Health Policy 

Résumé

Objectifs

Deux études ont fait état d’un risque accru de trouble autistique chez les enfants conçus moins de 12 mois après une naissance antérieure. Notre objectif était d’examiner l’association entre la période de non-gravidité (PNG) et les troubles du spectre de l’autisme (TSA) au sein d’une cohorte canadienne.

Méthode

À l’aide de jeux de données administratives stockés au Centre de la politique des soins de santé du Manitoba, nous avons identifié des paires familiales composées du premier-né et du deuxième enfant (accouchements simples) nés entre 1988 et 2005. Les diagnostics de TSA ont été obtenus en interrogeant les demandes de paiement des médecins, les registres des sorties des hôpitaux, les données relatives à l’éducation et une base de données contenant de l’information sur les personnes identifiées pour un programme de surveillance des TSA mené au Manitoba entre 2002 et 2007. Des modèles de régression logistique ont été adaptés pour examiner l’association entre la PNG et les TSA chez 41 050 frères et soeurs second-nés dont le frère ou la soeur né(e) en premier n’avait pas de TSA, en utilisant une PNG de ≥ 36 mois comme catégorie de référence et en précisant trois groupes de cas. Le 1er groupe de cas incluait les personnes avec au moins un code de TSA (n = 490); le 2e groupe de cas incluait celles avec deux codes de TSA ou plus (n = 375); et le 3e groupe de cas comprenait les personnes ayant un dossier dans la base de données du programme de surveillance des TSA (n = 141).

Résultats

Le rapport de cotes (RC) ajusté pour les PNG de moins de 12 mois variait entre 1,22 (IC de 95%: 0,91–1,63) pour le 1er groupe de cas à 1,72 (IC de 95 %: 0,96–3,06) pour le 3e groupe de cas. Lorsque les groupes de cas étaient limités aux personnes ayant un TSA grave, le RC augmentait, et il était significatif pour les 1er et 2e groupes de cas.

Conclusion

Nos constatations confirment également une association entre les PNG brèves et les TSA plus graves.

Mots Clés

autisme période de non-gravidité analyse secondaire données administratives couplage des dossiers Centre de la politique des soins de santé du Manitoba 

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Copyright information

© The Canadian Public Health Association 2015

Authors and Affiliations

  • Helen Coo
    • 1
    Email author
  • Hélène Ouellette-Kuntz
    • 2
  • Yuk-Miu Lam
    • 2
  • Marni Brownell
    • 3
    • 4
  • Michael P. Flavin
    • 1
  • Leslie L. Roos
    • 3
    • 4
  1. 1.Department of Public Health SciencesQueen’s UniversityKingstonCanada
  2. 2.Department of Public Health SciencesQueen’s UniversityKingstonCanada
  3. 3.Department of Community Health SciencesUniversity of ManitobaWinnipegCanada
  4. 4.Manitoba Centre for Health PolicyWinnipegCanada

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