Maternal Smoking During Pregnancy and the Risk of Psychiatric Morbidity in Singleton Sibling Pairs.
Maternal Smoking During Pregnancy and the Risk of Psychiatric Morbidity in Singleton Sibling Pairs.
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DOI：
10.1093/ntr/ntx001
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发表时间：
2017-05-01
期刊：
影响因子：
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通讯作者：
Gissler M
中科院分区：
文献类型：
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作者：
Ekblad M;Lehtonen L;Korkeila J;Gissler M
母亲在怀孕期间吸烟与精神疾病发病率的增加有关。我们对芬兰的兄弟姐妹进行了进一步的研究，以控制遗传/家庭因素。从芬兰医学出生登记中，选择兄弟姐妹作为1987-1995年出生的同一母亲的前两个孩子(n=150 168对)，以及关于母亲吸烟(不吸烟/吸烟)的信息。儿童的精神疾病诊断与门诊(1998-2013年)和住院(1987-2013年)有关，母亲的精神疾病发病率(1969-2013年)来自芬兰医院出院登记簿。第一对分析比较了在第一次怀孕期间只吸烟的母亲(戒烟者，4.7%)和在两次怀孕期间吸烟的母亲(吸烟者，9.6%)的兄弟姐妹；第二对分析包括只在第二次怀孕期间吸烟的母亲(3.3%)和在两次怀孕期间都不吸烟的母亲(77.5%)。5.0%的情侣没有吸烟信息。统计分析包括兄弟姐妹和母亲的精神疾病发病率。与吸烟者相比，戒烟者第二个孩子的精神疾病诊断风险显著降低(调整后的OR为0.77，95%CI为0.72-0.83)。与不吸烟的人相比，第二个孩子患精神疾病的风险更高(1.39，1.30-1.49)。吸烟对外部化诊断的作用更强。即使在完全控制遗传和家庭因素的情况下，母亲吸烟也独立地与儿童精神疾病发病率的更高风险相关。即使在采用同胞配对设计控制了不可测量的遗传/家庭因素之后，孕期母亲吸烟对儿童精神疾病的风险也有独立的影响。母亲吸烟对外部化诊断的影响是很强的。母亲怀孕期间吸烟对门诊和住院护理的诊断都有影响。
Maternal smoking during pregnancy has been associated with an increased risk for psychiatric morbidity. We further studied this with Finnish siblings to control for genetic/familial factors. From the Finnish Medical Birth Register, sibling pairs were selected as the first two children born 1987–1995 to the same mother (n = 150 168 pairs), along with information on maternal smoking (no smoking/smoking). Information on the children’s psychiatric diagnoses related to outpatient care visits (1998–2013) and inpatient care (1987–2013), and the mothers’ psychiatric morbidity (1969–2013) was derived from the Finnish Hospital Discharge Register. The first pair analysis compared siblings of mothers who only smoked in the first pregnancy (Quitters, 4.7%) and mothers who smoked in both pregnancies (Smokers, 9.6%); the second analysis included mothers who smoked only in the second pregnancy (Starters, 3.3%) and mothers who did not smoke in either pregnancy (Nonsmokers, 77.5%). Smoking information was missing for 5.0% of pairs. Psychiatric morbidity of the siblings and mother was included in the statistical analyses. The risk of psychiatric diagnoses was significantly lower for the second child of quitters (adjusted OR 0.77, 95% CI 0.72–0.83) compared to the risk among smokers. A higher risk for psychiatric diagnoses was found for the second child of starters (1.39, 1.30–1.49) compared to the risk among nonsmokers. The effect of smoking was more robust for externalizing diagnoses. Maternal smoking was independently associated with a higher risk for psychiatric morbidity in children, even when controlling thoroughly for genetic and familial factors. Maternal smoking during pregnancy has an independent effect on the risk of psychiatric morbidity in children, even after controlling for non-measurable genetic/familial factors by using a sibling pair design. The effect of maternal smoking was robust for externalizing diagnoses. Maternal smoking during pregnancy had an effect on diagnoses both in outpatient and inpatient care.