Stanford Family Medicine, Stanford University, Palo Alto, CA 94304-5765, USA.
Int J Epidemiol. 2010 Dec;39(6):1522-30. doi: 10.1093/ije/dyq103. Epub 2010 Jun 21.
Recent studies suggest an increased risk of adverse mental health outcomes among young adults who were born preterm. These studies have been based mainly on hospital data, thus missing large numbers of mental health problems that do not require inpatient treatment. We used national outpatient and inpatient pharmacy data to evaluate whether individuals who were born preterm were more likely to be prescribed psychiatric medications during young adulthood than individuals who were born full term.
A national cohort of all infants born in Sweden from 1973 through 1979 [N = 635,933, including 28,799 who were born preterm (<37 weeks)] was followed to ages 25.5-34.0 years to determine whether psychotropic medications (antidepressants, antipsychotics, anxiolytics, hypnotics/sedatives and/or psychostimulants) were prescribed in 2005-06.
A trend of increasing rate of prescriptions for antipsychotics, antidepressants and hypnotics/sedatives in young adulthood was observed by earlier gestational age at birth. Young adults who were extremely preterm at birth (23-27 weeks) were 3.1 times more likely to be prescribed antipsychotics [95% confidence interval (CI) 1.66-5.93], 1.8 times more likely to be prescribed antidepressants (95% CI 1.26-2.64) and 1.8 times more likely to be prescribed hypnotics/sedatives (95% CI 1.15-2.96) than individuals who were full term at birth, after adjusting for potential confounders.
This national cohort study, using outpatient and inpatient pharmacy data, suggests that preterm birth has important independent effects on mental health that extend at least into young adulthood.
最近的研究表明，早产儿出生的年轻成年人发生不良心理健康后果的风险增加。这些研究主要基于医院数据，因此错过了大量不需要住院治疗的心理健康问题。我们使用国家门诊和住院药房数据来评估早产儿出生的个体在年轻成年期比足月出生的个体更有可能被开处精神科药物。
对瑞典所有在 1973 年至 1979 年期间出生的婴儿（包括 28799 名早产儿(<37 周）的全国队列进行了随访，随访时间为 25.5-34.0 岁，以确定是否在 2005-06 年开处了精神药物（抗抑郁药、抗精神病药、抗焦虑药、催眠药/镇静剂和/或精神兴奋剂）。
通过出生时的更早的胎龄，观察到在年轻成年期抗精神病药、抗抑郁药和催眠药/镇静剂处方率的趋势呈上升趋势。出生时极早产儿（23-27 周）开处抗精神病药的可能性是足月出生的个体的 3.1 倍[95%置信区间 (CI) 1.66-5.93]，开处抗抑郁药的可能性是足月出生的个体的 1.8 倍[95%置信区间 (CI) 1.26-2.64]，开处催眠药/镇静剂的可能性是足月出生的个体的 1.8 倍[95%置信区间 (CI) 1.15-2.96]，这在调整了潜在的混杂因素后仍然成立。
这项全国队列研究使用门诊和住院药房数据，表明早产儿出生对心理健康有重要的独立影响，这种影响至少持续到年轻成年期。
