King-Hele Sarah A, Abel Kathryn M, Webb Roger T, Mortensen Preben B, Appleby Louis, Pickles Andrew R
Centre for Women's Mental Health Research, The University of Manchester, Manchester , England.
Arch Gen Psychiatry. 2007 Nov;64(11):1323-30. doi: 10.1001/archpsyc.64.11.1323.
Sudden infant death syndrome is the leading cause of postneonatal death in developed countries. Little is known about risks linked with parental mental illness per se or how such risks are modified by specific psychiatric conditions and by maternal vs paternal psychopathological abnormalities.
To investigate cause-specific postneonatal death, including sudden infant death syndrome, in infants whose parents had been admitted as psychiatric inpatients.
National cohort study.
The entire Danish population. Patients All of the singleton live births registered from January 1, 1973, to December 31, 1998. Linkage to the national psychiatric register enabled identification of all of the parental admissions from April 1, 1969, onward.
All of the cases of sudden infant death syndrome in the postneonatal period classified via national mortality registration between January 1, 1973, and December 31, 1998.
Psychiatric admission history in either parent doubled the risk of sudden infant death syndrome, but there was no difference in risk whether infants were exposed to maternal or paternal admission. Risk was particularly high if both parents had been admitted for any psychiatric disorder (relative risk, 6.9; 95% confidence interval, 4.1-11.6). Among specific parental disorders, the greatest risk was associated with admission for alcohol- or drug-related disorders (mothers: relative risk, 5.0; 95% confidence interval, 3.4-7.5; fathers: relative risk, 2.5; 95% confidence interval, 1.7-3.8). Contrary to prior expectation, parental schizophrenia and related disorders did not confer higher risks than other parental disorders that resulted in admission.
Infants whose parents have been admitted for psychiatric treatment are at greater risk for sudden infant death syndrome. However, risks may be lower than previously thought with maternal schizophrenia and related disorders. Clinicians should be aware of particularly high risks if both parents have received any psychiatric inpatient treatment or if either parent (but the mother especially) was admitted with an alcohol- or drug-related disorder.
在发达国家，婴儿猝死综合征是新生儿期后死亡的主要原因。对于与父母精神疾病本身相关的风险，以及这些风险如何因特定精神疾病状况以及母亲与父亲的精神病理异常而改变，人们知之甚少。
调查父母曾作为精神科住院患者的婴儿中特定原因的新生儿期后死亡情况，包括婴儿猝死综合征。
全国队列研究。
丹麦全体人口。患者为1973年1月1日至1998年12月31日登记的所有单胎活产儿。与国家精神科登记处的关联使得能够识别自1969年4月1日起的所有父母住院情况。
1973年1月1日至1998年12月31日期间通过国家死亡率登记分类的新生儿期后所有婴儿猝死综合征病例。
父母任何一方有精神科住院史会使婴儿猝死综合征风险加倍，但婴儿暴露于母亲或父亲住院情况时风险无差异。如果父母双方都因任何精神疾病住院，风险尤其高（相对风险，6.9；95%置信区间，4.1 - 11.6）。在特定的父母疾病中，最大风险与因酒精或药物相关疾病住院有关（母亲：相对风险，5.0；95%置信区间，3.4 - 7.5；父亲：相对风险，2.5；95%置信区间，1.7 - 3.8）。与先前预期相反，父母患精神分裂症及相关疾病并未比导致住院的其他父母疾病带来更高风险。
父母曾接受精神科治疗的婴儿患婴儿猝死综合征的风险更高。然而，母亲患精神分裂症及相关疾病时的风险可能低于先前认为的水平。临床医生应意识到，如果父母双方都接受过精神科住院治疗，或者父母任何一方（尤其是母亲）因酒精或药物相关疾病住院，风险会特别高。
