{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T21:05:48Z","timestamp":1788469548935,"version":"build-2803163510"},"reference-count":19,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,8,23]],"date-time":"2018-08-23T00:00:00Z","timestamp":1534982400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100005275","name":"Region Hovedstaden","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005275","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Child Psychology Psychiatry"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Increasing attention deficit hyperactivity disorder (\n                      <jats:styled-content style=\"fixed-case\">ADHD<\/jats:styled-content>\n                      ) incidence has been proposed to be caused by factors influencing microbiota in early life. We investigated the potential causality between\n                      <jats:styled-content style=\"fixed-case\">ADHD<\/jats:styled-content>\n                      and two surrogate markers for changes in children's microbiota: birth delivery mode and early childhood antibiotic use.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      This population\u2010based, prospective cohort study linked nationwide registers of data for native Danish singleton live births in Denmark from 1997 to 2010. Exposure variables were delivery mode and antibiotic use during the first 2\u00a0years of life. The main outcome measure was\n                      <jats:styled-content style=\"fixed-case\">ADHD<\/jats:styled-content>\n                      diagnosis or redeemed\n                      <jats:styled-content style=\"fixed-case\">ADHD<\/jats:styled-content>\n                      medication prescriptions. For statistical analysis, we used both advanced sibling models and a more traditional approach.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We included 671,592 children, followed from their second birthday in the period 1999\u20132014 for 7,300,522 person\u2010years.\n                      <jats:styled-content style=\"fixed-case\">ADHD<\/jats:styled-content>\n                      was diagnosed in 17,971. In total, 17.5% were born by cesarean delivery, and 72% received antibiotic treatment within their first 2\u00a0years of life. In the adjusted between\u2010within sibling survival model, mode of delivery or antibiotics had no effect on\n                      <jats:styled-content style=\"fixed-case\">ADHD<\/jats:styled-content>\n                      when compared with vaginal delivery or no antibiotic treatment as hazard ratios were 1.09 (95% confidence interval 0.97\u20131.24) for intrapartum cesarean, 1.03 (0.91\u20131.16) for prelabor cesarean, 0.98 (0.90\u20131.07) for penicillin, and 0.99 (0.92\u20131.06) for broader spectrum antibiotics. In a sibling\u2010stratified Cox regression, intrapartum cesarean was associated with increased\n                      <jats:styled-content style=\"fixed-case\">ADHD<\/jats:styled-content>\n                      risk, but other exposures were not. In a descriptive, nonstratified Cox model, we found increased risk for\n                      <jats:styled-content style=\"fixed-case\">ADHD<\/jats:styled-content>\n                      for all exposures.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Detailed family confounder control using the superior between\u2010within model indicates that cesarean delivery or use of antibiotics during the first 2\u00a0years of life does not increase\n                      <jats:styled-content style=\"fixed-case\">ADHD<\/jats:styled-content>\n                      risk. Therefore, our study suggests that changes in children's microbiota related to cesarean delivery or antibiotic use, do not cause\n                      <jats:styled-content style=\"fixed-case\">ADHD<\/jats:styled-content>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jcpp.12961","type":"journal-article","created":{"date-parts":[[2018,8,23]],"date-time":"2018-08-23T05:35:21Z","timestamp":1535002521000},"page":"151-159","source":"Crossref","is-referenced-by-count":53,"title":["Investigating the effects of cesarean delivery and antibiotic use in early childhood on risk of later attention deficit hyperactivity disorder"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8403-0084","authenticated-orcid":false,"given":"Paul Bryde","family":"Axelsson","sequence":"first","affiliation":[{"name":"Department of Gynaecology and Obstetrics Nordsjaellands Hospital University of Copenhagen Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tine Dalsgaard","family":"Clausen","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics Nordsjaellands Hospital University of Copenhagen Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Helby","family":"Petersen","sequence":"additional","affiliation":[{"name":"Department of Public Health Section of Biostatistics University of Copenhagen Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ida","family":"Hageman","sequence":"additional","affiliation":[{"name":"Psychiatric Center Copenhagen Copenhagen University Hospital, Rigshospitalet Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anja","family":"Pinborg","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Copenhagen University Hospital Hvidovre Hospital Hvidovre Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars Vedel","family":"Kessing","sequence":"additional","affiliation":[{"name":"Psychiatric Center Copenhagen Copenhagen University Hospital, Rigshospitalet Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Bergholt","sequence":"additional","affiliation":[{"name":"Department of Obstetrics University of Copenhagen, Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steen Christian","family":"Rasmussen","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology Copenhagen University Hospital, Hvidovre Hospital Hvidovre Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels","family":"Keiding","sequence":"additional","affiliation":[{"name":"Department of Public Health Section of Biostatistics University of Copenhagen Copenhagen 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