Amani Hamad

In June 2018, Amani presented “Prenatal Antibiotics Exposure and the Risk of Autism Spectrum Disorders” at the Society for Epidemiologic Research (SER) Annual Meeting in Baltimore, Maryland. Amani was kind enough to share about her research and experiences for the CNODES newsletter and website.

Can you give us a short summary of the research you presented at the Society for Epidemiologic Research (SER) meeting?

The prevalence of autism spectrum disorders (ASD) is increasing globally, but the exact etiology remains unclear. Studies have shown that people with ASD have abnormal composition of gut microbiota (i.e., the microorganisms residing in our bodies). Previous research has suggested that changes in microbiota composition due to prenatal antibiotic exposure may be associated with ASD development. The aim of our research project is to examine this association using 18 years of data from the Manitoba Population Research Data Repository. We identified a cohort of children born in Manitoba between 1998 to 2016 and determined their exposure to antibiotics prenatally. We followed them up and compared the rates of ASD diagnosis between those who were exposed to antibiotics and those who were not. To account for confounding by genetics and other shared familial factors, we additionally compared ASD risk within a cohort of exposure-discordant siblings. Our findings showed a 10% increase in ASD risk with prenatal antibiotic exposure. Given the potential for residual confounding, most importantly confounding by indication, we do not expect that such a small risk increase would be clinically significant.

Tell us about your experience presenting at the SER meeting.

It was a great honour to present my research to a large group of epidemiology experts from around the world. I very much appreciated the discussion after the presentation where I got valuable feedback. One epidemiologist at the conference suggested that we identify the indications for antibiotic classes found to be associated with ASD—to help understand the nature of the association and whether it is confounded by a specific indication. I later explored this issue and found that it was not the case. Aside from presenting, the conference was a great venue to meet other epidemiology researchers, to learn about their research projects, and about advances in epidemiological methods.

What excites you the most about the research you are doing or hope to do in the future?

Currently, I am investigating the long-term safety of medications used during critical periods of development, including pregnancy and early childhood. As a mother myself, I believe parents have the right to be aware of the potential harms associated with routinely prescribed medications. Recently, there have been a large number of observational studies connecting childhood diseases to medications used during these critical periods; however, causality cannot be confirmed. A lot of uncertainties remain in this field of research, which can be further explored using rigorous epidemiological study designs.

In an ideal world, where would you like to be career-wise in five years?

Teaching and research are my passions, and a job in academia, which will allow me to do both, is my ultimate goal. My hope is that the PhD program followed by a postdoctoral fellowship will provide me with the necessary skills to become a teacher and researcher, and to have a lasting and positive impact on future students, the healthcare system, and on patients.

How has CNODES impacted your studies or career trajectory?

CNODES has provided me with great training opportunities since I started my PhD program in 2015. In 2016, CNODES provided financial support to attend the Epidemiology Congress of the Americas, a conference that brings together epidemiologists from around the world. In 2017, I was supported to attend McGill Pharmacoepidemiology summer course where I learned about the principles of pharmacoepidemiology. This year, CNODES supported my attendance at the SER conference where I made an oral presentation of my research. Also, CNODES online training lectures are a valuable resource for me and my colleagues as pharmacoepidemiology researchers-in-training. While preparing for my candidacy exam, I found the online lectures on confounding and propensity scores a great starting point to understanding these concepts.

Outside of work and studies, what is one thing that you are really passionate about?

I’m passionate about baking. I love making cookies, muffins, and cupcakes. My chocolate chip cookies and pumpkin muffins are the most popular. And my favourite part is sharing them with family and friends.