The role of perinatal problems in risk of co-morbid psychiatric and medical disorders in adulthood.
The role of perinatal problems in risk of co-morbid psychiatric and medical disorders in adulthood.
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围产期问题在成年期共病精神和医学疾病风险中的作用。
DOI：
10.1017/s0033291707000736
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发表时间：
2007
影响因子：
6.9
通讯作者：
Fifer,WilliamP
中科院分区：
文献类型：
--
作者：
Nomura,Yoko;Brooks-Gunn,Jeanne;Davey,Charles;Ham,Jacob;Fifer,WilliamP
背景围产期问题可能与成年后心理和身体健康问题的风险增加有关，尽管尚不清楚哪些围产期问题（低出生体重、早产、低阿普加评分和头围小）或哪些问题群更有可能与以后的健康问题相关。也不清楚围产期问题（单独或共同）是否与心理和身体健康问题的合并症有关。方法对来自巴尔的摩的母亲及其子女（n=1525）进行区域随机抽样，从出生到成年（平均年龄29岁）。分娩时测量围产期情况。心理问题（抑郁和自杀意念）用一般健康问卷-28 （GHQ-28）测量，身体问题（哮喘和高血压）用RAND-36健康状况量表测量。结果围产期问题患儿出现抑郁、自杀意念和高血压的风险普遍较高，即使在控制混杂因素后也存在抑郁和高血压并病的风险。考虑到所有四种围产期问题，通过聚类分析提取出的一个可能的潜在条件，早产低出生体重（LBW），与心理和身体健康结局以及两者合并症的风险增加有关。结论低体重、早产和小头围单独增加了心理和生理健康问题以及合并抑郁和高血压的风险，而低Apgar评分仅与心理问题相关。描述不同的病因过程，如早产儿腰重，同时考虑各种围产期问题，可能有助于了解成人疾病和合并症的胎儿起源。
BackgroundPerinatal problems may be associated with an increased risk for psychological and physical health problems in adulthood, although it is unclear which perinatal problems (low birthweight, preterm birth, low Apgar scores, and small head circumference), or what clusters of problems, are more likely to be associated with later health problems. It is also not known whether perinatal problems (singly or together) are associated with co-morbidity between psychological and physical health problems.MethodA regional random sample (from Baltimore) of mothers and their children (n=1525) was followed from birth to adulthood (mean age 29 years). Perinatal conditions were measured at delivery. Psychological problems (depression and suicidal ideation) were measured with the General Health Questionnaire-28 (GHQ-28) and physical problems (asthma and hypertension) with the RAND-36 Health Status Inventory.ResultsChildren with perinatal problems were generally at increased risk for depression, suicidal ideation and hypertension, and co-morbid depression and hypertension even after controlling for confounders. One possible underlying condition, preterm low birthweight (LBW), extracted by cluster analysis, considering all of the four perinatal problems, was associated with increased risk for psychological and physical health outcomes as well as co-morbidity of the two.ConclusionsLBW, preterm birth and small head circumference singly increased the risk for both psychological and physical health problems, as well as co-morbid depression and hypertension, while low Apgar scores were only associated with psychological problems. Delineating different etiological processes, such as preterm LBW, considering various perinatal problems simultaneously, might be of benefit to understanding the fetal origin of adult illness and co-morbidity.