Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
Neuroscience Graduate Program, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
J Child Psychol Psychiatry. 2018 May;59(5):596-603. doi: 10.1111/jcpp.12826. Epub 2017 Oct 2.
Preterm birth is associated with an increased risk of depression and anxiety, but it is not known if this is due to greater exposure to risk, or if perinatal adversity amplifies the impact of traditional risk factors. This study sought to determine if exposure to perinatal adversity modifies associations between traditional risk and resilience factors and depression and anxiety in adulthood.
A sample of 142 extremely low-birth-weight (ELBW < 1,000 g) survivors and 133 sociodemographically matched normal birth weight (NBW) control participants was followed longitudinally to 22-26 years of age. Separate postnatal risk and resilience scales were created using eight risk and seven resilience factors, respectively. Depression and anxiety were assessed using the internalizing scale of the Young Adult Self-Report (YASR). This scale was also dichotomized at the 90th percentile to define clinically significant psychopathology.
While the average number of risk exposures did not differ between groups, ELBW survivors were more susceptible to risk than NBW control participants. For the ELBW group, each additional risk factor resulted in a 2-point increase in internalizing scores, and two and a half times the odds of clinically significant internalizing symptoms (OR = 2.47, 95% CI = 1.63, 3.76). The protective effect of resiliency factors was also blunted among ELBW survivors.
Extremely low-birth-weight survivors may be more sensitive to traditional risk factors for psychopathology and less protected by resiliency factors. Intervention strategies aimed at preventing or reducing exposure to traditional childhood risk factors for psychopathology may reduce the burden of mental illness in adult survivors of prematurity.
早产与抑郁和焦虑的风险增加有关，但尚不清楚这是由于接触更多的风险因素，还是围产期逆境放大了传统风险因素的影响。本研究旨在确定围产期逆境是否会改变传统风险和适应因素与成年后抑郁和焦虑之间的关联。
一项对 142 名极低出生体重（ELBW <1000g）幸存者和 133 名社会人口统计学匹配的正常出生体重（NBW）对照组参与者的样本进行了纵向随访，随访时间为 22-26 岁。分别使用 8 个风险因素和 7 个适应因素创建了单独的产后风险和适应量表。使用内部化量表（青年成人自评量表，YASR）评估抑郁和焦虑。该量表也在第 90 百分位数上进行了二分法，以定义临床上显著的精神病理学。
尽管两组的平均风险暴露数量没有差异，但 ELBW 幸存者比 NBW 对照组参与者更容易受到风险的影响。对于 ELBW 组，每增加一个风险因素，内部化评分就会增加 2 分，且出现临床上显著的内部化症状的几率增加 2.5 倍（OR=2.47，95%CI=1.63，3.76）。适应因素的保护作用在 ELBW 幸存者中也减弱了。
极低出生体重幸存者可能对精神病理学的传统风险因素更为敏感，而对适应因素的保护作用较弱。旨在预防或减少精神病理学传统儿童风险因素暴露的干预策略，可能会降低早产儿成年幸存者的精神疾病负担。
