Abel Kathryn M, Wicks Susanne, Susser Ezra S, Dalman Christina, Pedersen Marianne G, Mortensen Preben Bo, Webb Roger T
Centre for Women's Mental Health, University of Manchester, England.
Arch Gen Psychiatry. 2010 Sep;67(9):923-30. doi: 10.1001/archgenpsychiatry.2010.100.
Studies linking birth weight and mental illness onset are inconclusive. They have primarily focused on the World Health Organization low birth weight threshold (2500 g) and schizophrenia. To our knowledge, low birth weight per se has not been conclusively linked with schizophrenia risk and specificity of the effect to birth weight below the standard threshold or to particular psychiatric diagnoses has not been demonstrated.
To examine whether (1) low birth weight (<2500 g) is associated with increased risk for adult schizophrenia; (2) risk extends into the normal weight range; and (3) risk is confined to schizophrenia or linked to other adult mental illnesses.
Population-based cohort study.
Sweden and Denmark.
Singleton live births in Sweden (1973-1984) and Denmark (1979-1986) (N = 1.49 million). Births were linked to comprehensive national registers of psychiatric treatment, with follow-up to December 31, 2002 (Sweden), or to June 30, 2005 (Denmark). There were 5445 cases of schizophrenia and 57 455 cases of any adult psychiatric disorder.
Crude and adjusted odds ratios for birth weight less than or more than 3500 to 3999 g in consecutive 500-g strata (from 500-1499 g to > or =4500 g) for schizophrenia, any psychiatric diagnoses, and specified psychiatric diagnoses.
Schizophrenia was associated with birth weight less than 2500 g. The association was not restricted to birth weight less than 2500 g and there was a significant linear trend of increasing odds ratios with decreasing birth weight across the birth weight range. This was mirrored for any psychiatric diagnosis and for each of the categories of psychiatric disorder.
Findings suggest there is an association between birth weight and adult mental disorder, but there is no indication this effect is specific to birth weight less than 2500 g or to schizophrenia. Future research should explore common disorder-specific mechanisms that may link birth weight to development of psychiatric disorder in adulthood.
关于出生体重与精神疾病发病之间关系的研究尚无定论。这些研究主要聚焦于世界卫生组织的低出生体重阈值（2500克）和精神分裂症。据我们所知，低出生体重本身与精神分裂症风险之间尚未建立确凿联系，且未证明该效应对于低于标准阈值的出生体重或特定精神疾病诊断具有特异性。
研究（1）低出生体重（<2500克）是否与成人精神分裂症风险增加相关；（2）风险是否延伸至正常体重范围；（3）风险是否仅限于精神分裂症或与其他成人精神疾病相关。
基于人群的队列研究。
瑞典和丹麦。
瑞典（1973 - 1984年）和丹麦（1979 - 1986年）的单胎活产婴儿（N = 149万）。出生记录与国家全面精神科治疗登记册相关联，随访至2002年12月31日（瑞典）或2005年6月30日（丹麦）。有5445例精神分裂症病例和57455例任何成人精神疾病病例。
按连续的500克分层（从500 - 1499克到≥4500克），计算出生体重小于或大于3500至3999克时，精神分裂症、任何精神疾病诊断以及特定精神疾病诊断的粗比值比和调整后比值比。
精神分裂症与出生体重小于2500克相关。该关联不限于出生体重小于2500克，且在整个出生体重范围内，随着出生体重降低，比值比呈显著线性增加趋势。对于任何精神疾病诊断以及每类精神疾病，情况均如此。
研究结果表明出生体重与成人精神疾病之间存在关联，但没有迹象表明这种效应对于出生体重小于2500克或精神分裂症具有特异性。未来研究应探索可能将出生体重与成人期精神疾病发展联系起来的常见疾病特异性机制。
