胎儿生长与精神及社会经济问题：基于人群的兄弟姐妹比较研究
Fetal growth and psychiatric and socioeconomic problems: population-based sibling comparison.
作者信息
Class Quetzal A, Rickert Martin E, Larsson Henrik, Lichtenstein Paul, D'Onofrio Brian M
机构信息
Quetzal A. Class, BS, Martin E. Rickert, PhD, Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana; Henrik Larsson, PhD, Paul Lichtenstein, PhD, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Brian M. D'Onofrio, PhD, Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana.
出版信息
Br J Psychiatry. 2014 Nov;205(5):355-61. doi: 10.1192/bjp.bp.113.143693. Epub 2014 Sep 25.
BACKGROUND
It is unclear whether associations between fetal growth and psychiatric and socioeconomic problems are consistent with causal mechanisms.
AIMS
To estimate the extent to which associations are a result of unmeasured confounding factors using a sibling-comparison approach.
METHOD
We predicted outcomes from continuously measured birth weight in a Swedish population cohort (n = 3 291 773), while controlling for measured and unmeasured confounding.
RESULTS
In the population, lower birth weight (⩽ 2500 g) increased the risk of all outcomes. Sibling-comparison models indicated that lower birth weight independently predicted increased risk for autism spectrum disorder (hazard ratio for low birth weight = 2.44, 95% CI 1.99-2.97) and attention-deficit hyperactivity disorder. Although attenuated, associations remained for psychotic or bipolar disorder and educational problems. Associations with suicide attempt, substance use problems and social welfare receipt, however, were fully attenuated in sibling comparisons.
CONCLUSIONS
Results suggest that fetal growth, and factors that influence it, contribute to psychiatric and socioeconomic problems.
背景
胎儿生长与精神疾病及社会经济问题之间的关联是否符合因果机制尚不清楚。
目的
采用同胞比较法估计这些关联在多大程度上是由未测量的混杂因素导致的。
方法
在一个瑞典人群队列（n = 3291773）中，我们根据连续测量的出生体重预测结果，同时控制已测量和未测量的混杂因素。
结果
在总体人群中，较低的出生体重（≤2500g）会增加所有结果的风险。同胞比较模型表明，较低的出生体重独立预测了自闭症谱系障碍（低出生体重的风险比 = 2.44，95%置信区间1.99 - 2.97）和注意力缺陷多动障碍风险增加。虽然有所减弱，但与精神分裂症或双相情感障碍以及教育问题的关联仍然存在。然而，在同胞比较中，与自杀未遂、物质使用问题和社会福利领取的关联完全减弱。
结论
结果表明，胎儿生长及其影响因素会导致精神疾病和社会经济问题。
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