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30 多岁极低出生体重儿幸存者的心理健康。

Mental health of extremely low birth weight survivors in their 30s.

机构信息

Departments of Psychiatry and Behavioural Neurosciences,

Departments of Psychiatry and Behavioural Neurosciences.

出版信息

Pediatrics. 2015 Mar;135(3):452-9. doi: 10.1542/peds.2014-3143. Epub 2015 Feb 9.

Abstract

OBJECTIVE

To determine the risk for psychiatric disorders among extremely low birth weight (ELBW) survivors in their early to mid-30s and to determine whether those born small for gestational age or those exposed to a full course of antenatal corticosteroids (ACS) were at particularly high risk.

METHODS

A prospective, longitudinal, population-based cohort of 84 ELBW survivors and 90 normal birth weight (NBW) control participants born in Ontario, Canada from 1977 to 1982 were assessed by interviewers naive to birth weight status using the Mini-International Neuropsychiatric Interview.

RESULTS

ELBW survivors had lower odds of an alcohol or substance use disorder but higher odds of current non-substance-related psychiatric problems (odds ratio [OR] = 2.47; 95% confidence interval [CI], 1.19-5.14). Those born ELBW and SGA exhibited the same patterns with larger effects. ACS-exposed ELBW survivors had even higher odds of any current non-substance-related psychiatric disorder (OR = 4.41; 95% CI, 1.65-11.82), particularly generalized anxiety disorder (OR = 3.42; 95% CI, 1.06-11.06), the generalized type of social phobia (OR = 5.80; 95% CI, 1.20-27.99), and the inattentive subtype of attention-deficit/hyperactivity disorder (OR = 11.45; 95% CI, 2.06-63.50).

CONCLUSIONS

In their early to mid-30s, ELBW survivors were less likely to have alcohol or substance use disorders but may be at greater risk for other psychiatric problems. Those exposed to ACS were at especially high risk and manifested no reduction in alcohol or substance use disorders. ELBW survivors exposed to ACS may be a special group at risk for psychopathology in adulthood.

摘要

目的

确定极低出生体重(ELBW)幸存者在 30 多岁早期至中期患精神障碍的风险,并确定那些出生时体重不足或接受全程产前皮质类固醇(ACS)治疗的人是否存在极高的风险。

方法

对 1977 年至 1982 年在加拿大安大略省出生的 84 名 ELBW 幸存者和 90 名正常出生体重(NBW)对照参与者进行了前瞻性、纵向、基于人群的队列研究,由对出生体重状况一无所知的访谈者使用 Mini-国际神经精神访谈进行评估。

结果

ELBW 幸存者患酒精或物质使用障碍的可能性较低,但当前非物质相关精神问题的可能性较高(比值比 [OR] = 2.47;95%置信区间 [CI],1.19-5.14)。出生时体重不足且宫内生长受限的幸存者表现出相同的模式,影响更大。接受 ACS 治疗的 ELBW 幸存者出现任何当前非物质相关精神障碍的可能性更高(OR = 4.41;95% CI,1.65-11.82),尤其是广泛性焦虑障碍(OR = 3.42;95% CI,1.06-11.06)、广泛性社交恐惧症(OR = 5.80;95% CI,1.20-27.99)和注意力缺陷/多动障碍的注意力不集中亚型(OR = 11.45;95% CI,2.06-63.50)。

结论

在他们 30 多岁早期至中期,ELBW 幸存者患酒精或物质使用障碍的可能性较低,但可能面临更大的其他精神问题风险。暴露于 ACS 的人风险特别高,并且没有减少酒精或物质使用障碍。暴露于 ACS 的 ELBW 幸存者可能是成年后患精神病理学的一个特殊群体。

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