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[产科并发症与婴儿日后患精神分裂症:对产科医生的一种新的法医学威胁?]

[Obstetrical complications and further schizophrenia of the infant: a new medicolegal threat to the obstetrician?].

作者信息

Boog G

机构信息

Service de Gynécologie-Obstétrique, Pavillon Mère et Enfant, Hôtel-Dieu, 7, quai Moncousu, 44093 Nantes.

出版信息

J Gynecol Obstet Biol Reprod (Paris). 2003 Dec;32(8 Pt 1):720-7.

Abstract

Schizophrenia is a multifactorial disease with complex interactions between a genetic liability, possible perinatal complications and exposure to later environmental risk factors in childhood. Maternal influenza infection, wartime-famine-related denutrition and maternal depression or exposure to repeated stress in pregnancy may have a deleterious effect on brain development and neuronal migration. Obstetrical complications which are significantly associated with schizophrenia are bleeding, diabetes, prematurity, fetal growth retardation, Rhesus incompatibility, preeclampsia and congenital malformations. Subjects with onset of schizophrenia before age 22 had more often a history of acute fetal distress (abnormal presentation at birth and complicated cesarean delivery). Obstetrical complications may have a direct negative impact on fetal brain development or may be on the causal pathway between prepartum maternal depression or psychosis, exposure to stress and impaired relation between mother and child consecutive to postnatal depression.

摘要

精神分裂症是一种多因素疾病,在遗传易感性、可能的围产期并发症以及童年期后期暴露于环境危险因素之间存在复杂的相互作用。母亲感染流感、战时饥荒相关的营养不良、母亲抑郁或孕期反复暴露于压力下,可能会对大脑发育和神经元迁移产生有害影响。与精神分裂症显著相关的产科并发症包括出血、糖尿病、早产、胎儿生长受限、恒河猴血型不相容、先兆子痫和先天性畸形。22岁之前发病的精神分裂症患者更常出现急性胎儿窘迫史(出生时胎位异常和复杂剖宫产)。产科并发症可能对胎儿大脑发育有直接负面影响,或者可能处于产前母亲抑郁或精神病、暴露于压力以及产后抑郁导致的母婴关系受损之间的因果路径上。

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