Washington University School of Medicine, USA.
J Am Acad Child Adolesc Psychiatry. 2013 Mar;52(3):309-18. doi: 10.1016/j.jaac.2012.12.005. Epub 2013 Feb 4.
Preterm children are at greater risk for psychiatric disorders, including anxiety disorders and attention-deficit/hyperactivity disorder (ADHD), than their term-born peers. Prior research has focused primarily on children born at early gestational ages. Less is known about the rate of psychiatric disorders among late preterm or early term children. In addition, whether a history of maternal depression also associated with prematurity has an impact on the risk for psychiatric disorders remains underexplored.
Preschoolers between ages 3 and 6 years (N = 306) were recruited for a study examining preschool depression that included healthy and disruptive preschoolers. Preschoolers were placed in the following groups: late preterm (34-36 weeks, n = 39), early term (37-39 weeks, n = 78), and full term (40-41 weeks, n = 154). DSM-IV psychiatric disorders were assessed via the Preschool Age Psychiatric Assessment. Maternal history of psychiatric disorders was assessed using the Family Interview for Genetic Studies.
Late preterm children had higher rates of any Axis I psychiatric diagnosis (odds ratio = 3.18, 95% confidence interval = 1.09-4.76) and of any anxiety disorder (odds ratio = 3.74, 95% confidence interval = 1.59-8.78) than full term children after adjusting for gender, ethnicity, family income, and IQ. There were no differences in rates of psychiatric diagnoses between early term and full term children. A history of maternal depression mediated the relationship between late preterm birth and anxiety disorders in preschoolers.
Late preterm children were at increased risk for anxiety disorders at preschool age. A history of maternal depression mediated this association. Findings confirm the extension of the risk of psychiatric disorders associated with prematurity to the late preterm group, and suggest that maternal depression may play a key role in this risk trajectory.
早产儿患精神障碍的风险高于足月出生的同龄人，包括焦虑障碍和注意缺陷多动障碍（ADHD）。先前的研究主要集中在早期妊娠出生的儿童。关于晚期早产儿或早期足月产儿童的精神障碍发生率知之甚少。此外，母亲抑郁史与早产相关是否也会影响精神障碍的风险仍未得到充分探索。
研究招募了 3 至 6 岁的学龄前儿童（N=306），该研究检查了包括健康和行为障碍的学龄前儿童的学龄前抑郁。将学龄前儿童分为以下三组：晚期早产儿（34-36 周，n=39）、早期足月产（37-39 周，n=78）和足月产（40-41 周，n=154）。通过《学龄前儿童精神评估》评估 DSM-IV 精神障碍。使用《家庭访谈遗传研究》评估母亲的精神病史。
调整性别、种族、家庭收入和智商后，与足月产儿童相比，晚期早产儿的任何轴 I 精神诊断（优势比=3.18，95%置信区间=1.09-4.76）和任何焦虑障碍（优势比=3.74，95%置信区间=1.59-8.78）的发生率更高。早期足月产和足月产儿童在精神诊断率方面没有差异。母亲抑郁史中介了晚期早产儿出生与学龄前儿童焦虑障碍之间的关系。
晚期早产儿在学龄前患焦虑障碍的风险增加。母亲抑郁史中介了这种关联。研究结果证实了与早产相关的精神障碍风险扩展到晚期早产儿群体，并表明母亲抑郁可能在这种风险轨迹中发挥关键作用。
