Departments of Psychiatry, New York University School of Medicine, New York, NY, USA.
Bipolar Disord. 2013 Feb;15(1):92-9. doi: 10.1111/bdi.12015. Epub 2012 Nov 29.
Pregnant women exposed to an acute traumatic event are thought to produce offspring with an increased incidence of affective disorders. It is not known whether there are specific times in pregnancy which confer increased vulnerability, or if psychosocial stress alone can increase the incidence of affective disorders in offspring. We examined the relationship of the timing of an acute psychosocial threat during pregnancy to the incidence of affective disorders in offspring using data from a large birth cohort.
Using data on 90079 offspring born in Jerusalem in 1964-1976 and linked to Israel's psychiatric registry, we constructed proportional hazards models to evaluate the link between gestational age during the Arab-Israeli war of June 1967 and incidence of mood disorders.
Those in their first trimester of fetal development during the war were more likely to be admitted to hospitals for any mood disorders [relative risk (RR) = 3.01, 95% confidence interval (CI): 1.68-5.39, p = 0.0002]; for bipolar disorder the risk was doubled (RR = 2.44, 95% CI: 0.996-5.99, p = 0.054) and for all 'other' mood disorders the risk was tripled (RR = 3.61, 95% CI: 1.68-7.80, p = 0.001). Mood disorders were also increased in offspring whose mothers had been in the third month of pregnancy in June of 1967 (RR = 5.54, 95% CI: 2.73-11.24, p < 0.0001).
A time-limited exposure to a severe threat during early gestation may be associated with an increased incidence of affective disorders in offspring. The third month of fetal development was a moment of special vulnerability.
据认为，暴露于急性创伤性事件的孕妇所生子女患情感障碍的发病率增加。目前尚不清楚妊娠期间是否存在特定时间会增加易感性，还是单纯的心理社会压力就会增加子女患情感障碍的发病率。我们利用来自大型出生队列的数据，检查了妊娠期间急性心理社会威胁发生时间与子女情感障碍发病之间的关系。
利用 1964 年至 1976 年在耶路撒冷出生的 90079 名子女的数据，并与以色列精神科登记处相关联，我们构建了比例风险模型，以评估 1967 年 6 月的阿拉伯-以色列战争期间的胎儿发育第一孕期与情绪障碍发病之间的关系。
在战争期间处于胎儿发育第一孕期的人更有可能因任何情绪障碍住院（相对风险 [RR] = 3.01，95%置信区间 [CI]：1.68-5.39，p = 0.0002）；双相情感障碍的风险增加了一倍（RR = 2.44，95%CI：0.996-5.99，p = 0.054），而所有“其他”情绪障碍的风险增加了两倍（RR = 3.61，95%CI：1.68-7.80，p = 0.001）。如果母亲在 1967 年 6 月怀孕第三个月，子女的情绪障碍也会增加（RR = 5.54，95%CI：2.73-11.24，p < 0.0001）。
在妊娠早期，限时暴露于严重威胁可能与子女情感障碍发病率增加有关。胎儿发育的第三个月是一个特别脆弱的时期。
