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孕期发热和感染与 11 岁后代出现类精神病体验。丹麦全国出生队列前瞻性研究。

Fever and infections during pregnancy and psychosis-like experiences in the offspring at age 11. A prospective study within the Danish National Birth Cohort.

机构信息

Department of Public Health,University of Southern Denmark,Esbjerg,Denmark.

Section of Social Medicine, Department of Public Health,University of Copenhagen,Copenhagen,Denmark.

出版信息

Psychol Med. 2018 Feb;48(3):426-436. doi: 10.1017/S0033291717001805. Epub 2017 Jul 24.

DOI:10.1017/S0033291717001805
PMID:28735583
Abstract

BACKGROUND

Maternal exposures to fever and infections in pregnancy have been linked to subsequent psychiatric morbidity in the child. This study examined whether fever and common infections in pregnancy were associated with psychosis-like experiences (PLEs) in the child.

METHODS

A longitudinal study of 46 184 children who participated in the 11-year follow-up of the Danish National Birth Cohort was conducted. Pregnant women were enrolled between 1996 and 2002 and information on fever, genitourinary infections, respiratory tract infection, and influenza-like illness during pregnancy was prospectively collected in two interviews during pregnancy. PLEs were assessed using the seven-item Adolescent Psychotic-Like Symptom Screener in a web-based questionnaire completed by the children themselves at age 11.

RESULTS

PLEs were reported among 11% of the children. Multinomial logistic regression models with probability weights to adjust for potential selection bias due to attrition suggested that maternal fever, genitourinary infections and influenza-like illness were associated with a weak to moderate increased risk of subclinical psychosis-like symptoms in the offspring, whereas respiratory tract infections were not. No clear pattern was observed between the strengths of the associations and the timing of exposure, or the type of psychosis-like symptom.

CONCLUSIONS

In this study, maternal exposures to fevers and common infections in pregnancy were generally associated with a subtle excess risk of PLEs in the child. A more pronounced association was found for influenza-like illness under an a priori definition, leaving open the possibility that certain kinds of infections may constitute important risk factors.

摘要

背景

母体在怀孕期间发热和感染与儿童随后出现的精神发病有关。本研究检验了妊娠期间发热和常见感染是否与儿童出现类精神病体验(PLE)有关。

方法

对 46184 名儿童进行了一项纵向研究,这些儿童参加了丹麦国家出生队列的 11 年随访。孕妇于 1996 年至 2002 年期间入组,怀孕期间通过两次妊娠访谈前瞻性收集发热、泌尿道感染、呼吸道感染和流感样疾病的信息。在儿童 11 岁时,通过基于网络的问卷,使用 7 项青少年类精神病样症状筛查器来评估 PLE。

结果

11%的儿童报告了 PLE。使用概率权重的多项逻辑回归模型进行调整,以因失访导致的潜在选择偏差,结果表明母体发热、泌尿道感染和流感样疾病与后代出现亚临床类精神病样症状的风险轻度到中度增加相关,而呼吸道感染则不然。在暴露时间或类精神病样症状类型方面,没有观察到关联强度与暴露之间的明显关系。

结论

在这项研究中,母体在怀孕期间发热和常见感染通常与儿童出现 PLE 的微妙过度风险相关。根据预先定义,发现流感样疾病的关联更显著,这使得某些感染可能构成重要的危险因素的可能性依然存在。

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