Associations Between Maternal Infection During Pregnancy, Childhood Infections, and the Risk of Subsequent Psychotic Disorder-A Swedish Cohort Study of Nearly 2 Million Individuals
Associations Between Maternal Infection During Pregnancy, Childhood Infections, and the Risk of Subsequent Psychotic Disorder-A Swedish Cohort Study of Nearly 2 Million Individuals
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DOI：
10.1093/schbul/sbv112
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发表时间：
2016-01-01
影响因子：
6.6
通讯作者：
Dalman, Christina
中科院分区：
文献类型：
--
作者：
Blomstrom, Asa;Karlsson, Hakan;Dalman, Christina
目的：最近的研究质疑与产前接触感染相关的精神障碍风险是由于感染本身，还是由于感染和精神障碍的共同易感性。此外，产前感染与儿童时期严重感染（精神障碍的另一个所谓危险因素）之间的潜在联系仍然未知。本研究的目的是调查孕期母亲感染在父母精神疾病和随后的儿童感染中的作用。方法：1978-1997 年在瑞典出生的所有儿童都与国家患者登记册相关联。根据与怀孕期间母亲感染相关的非情感性精神病的风险比进行了估计，并根据与怀孕期间母亲感染之间的关系计算了儿童感染的比值比。相互作用导致的相对过度风险（RERI）估计了父母精神疾病与孕期母亲感染之间以及孕期母亲感染与儿童感染之间的生物协同作用。结果：母亲妊娠期间感染与后代精神病之间无统计学显着相关性（调整后风险比：1.06，95% CI 0.88-1.27）。然而，孕期母亲感染和母亲精神疾病在后代精神病的发展中协同作用（RERI 1.33，95% CI 0.27-2.38）。孕期母亲感染会增加后代儿童感染的风险（OR 1.50，95% CI 1.45-1.54）。这两个因素在精神病的发展中也相互作用（RERI 0.63，95% CI 0.12-1.14）。结论：在有精神疾病史的母亲中，怀孕期间感染会增加后代患精神病的风险。怀孕期间的母亲感染似乎会增加儿童感染的风险，从而使儿童更容易患上精神病。
Objective: Recent studies question whether the risk for psychotic disorder associated with prenatal exposure to infection are due to infections per se, or to shared susceptibility of both infections and psychiatric disorders. Moreover, the potential link between prenatal infection and serious infections during childhood, another alleged risk factor for psychotic disorder, remains unknown. The aim of this study was to investigate the role of maternal infections during pregnancy in context of parental psychiatric disorders and subsequent childhood infections. Method: All children born in Sweden 1978-1997 were linked to the National Patient Register. Hazard ratios of nonaffective psychosis were estimated in relation to maternal infection during pregnancy and odds ratios of childhood infection were calculated in relation to maternal infection during pregnancy. Relative excess risk due to interaction (RERI) estimated biological synergism between parental psychiatric disorder and maternal infection during pregnancy, and between maternal infection during pregnancy and childhood infection. Results: Maternal infection during pregnancy was not statistically significantly associated with offspring psychosis (adjusted hazard ratio: 1.06, 95% CI 0.88-1.27). However, maternal infection during pregnancy and maternal psychiatric disorders acted synergistically in offspring psychosis development (RERI 1.33, 95% CI 0.27-2.38). Maternal infection during pregnancy increased the risk of offspring childhood infections (OR 1.50, 95% CI 1.45-1.54). These 2 factors also interacted in psychosis development (RERI 0.63, 95% CI 0.12-1.14). Conclusions: Among mothers with a history of psychiatric disease, infection during pregnancy increases the risk of psychosis in offspring. Maternal infections during pregnancy appear to contribute to the risk of childhood infections, which together render the child more vulnerable to psychosis development.