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巴西南部出生队列中胎儿期和儿童期生长对成年早期抑郁症的影响。

The Effect of Fetal and Childhood Growth over Depression in Early Adulthood in a Southern Brazilian Birth Cohort.

作者信息

Loret de Mola Christian, Quevedo Luciana de Avila, Pinheiro Ricardo Tavares, Gonçalves Helen, Gigante Denise Petrucci, Motta Janaína Vieira Dos Santos, Barros Fernando C, Horta Bernardo Lessa

机构信息

Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.

Postgraduate Program in Health and Behavior, Universidade Católica de Pelotas, Pelotas, Brazil.

出版信息

PLoS One. 2015 Oct 15;10(10):e0140621. doi: 10.1371/journal.pone.0140621. eCollection 2015.

Abstract

BACKGROUND

Poor nutrition and growth during fetal life and childhood might be associated with depression in adulthood; however, studies evaluating these associations present controversial results, especially when comparing studies using different proxies for fetal growth. We evaluated the association of fetal and childhood growth/nutrition with depression, in adulthood, using different approaches and measurement methods.

METHOD

In 1982, hospital births (n = 5914) in Pelotas, southern Brazil, were examined and have been prospectively followed. At 30 years, the presence of major depression and depressive symptoms severity was evaluated using the Mini International Neuropsychiatric Interview (MINI) and Beck Depression Inventory (BDI-II). The present study assessed their association with birth weight, premature birth, small for gestational age (SGA), stunting and conditional growth during childhood.

RESULTS

At 30 years, 3576 individuals were evaluated and 7.9% had major depression. Low birth weight (PR = 1.01 95%CI [0.64-1.60]), having been born SGA (PR = 0.87 95%CI [0.64-1.19]) and premature birth (PR = 1.22 95%CI [0.72-2.07]) were not associated with major depression in multivariable models. However, those born SGA who were also stunted in childhood had a higher prevalence of major depression (PR = 1.87 95%CI [1.06-3.29]) and greater odds of scoring a higher level of depression in the BDI-II (OR = 2.18 95%CI [1.34-3.53]).

CONCLUSION

In this Brazilian cohort of young adults, those born SGA who were also stunted during childhood had a higher risk of depression in adulthood. Our results show that the effect of growth impairment on depression is cumulative.

摘要

背景

胎儿期和儿童期的营养不良及生长发育不良可能与成年期抑郁症有关;然而,评估这些关联的研究结果存在争议,尤其是在比较使用不同胎儿生长指标的研究时。我们采用不同方法和测量手段,评估了胎儿期和儿童期生长发育/营养状况与成年期抑郁症之间的关联。

方法

1982年,对巴西南部佩洛塔斯市的5,914例医院分娩病例进行了检查,并进行了前瞻性随访。在30岁时,使用迷你国际神经精神访谈(MINI)和贝克抑郁量表(BDI-II)评估了重度抑郁症的存在情况及抑郁症状的严重程度。本研究评估了这些情况与出生体重、早产、小于胎龄儿(SGA)、发育迟缓以及儿童期条件性生长之间的关联。

结果

在30岁时,对3,576名个体进行了评估,其中7.9%患有重度抑郁症。在多变量模型中,低出生体重(PR = 1.01,95%CI [0.64 - 1.60])、小于胎龄儿出生(PR = 0.87,95%CI [0.64 - 1.19])和早产(PR = 1.22,95%CI [0.72 - 2.07])与重度抑郁症无关。然而,那些出生时为小于胎龄儿且儿童期发育迟缓的人患重度抑郁症的患病率更高(PR = 1.87,95%CI [1.06 - 3.29]),并且在BDI-II中抑郁得分较高的几率更大(OR = 2.18,95%CI [1.34 - 3.53])。

结论

在这个巴西年轻成年人队列中,那些出生时为小于胎龄儿且儿童期发育迟缓的人成年后患抑郁症的风险更高。我们的结果表明,生长发育障碍对抑郁症的影响是累积性的。

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