School of Public Health, University of Montreal, Montreal, QC, Canada.
University of Montreal Hospital Research Centre, Montreal, QC, Canada.
Arch Womens Ment Health. 2018 Aug;21(4):437-444. doi: 10.1007/s00737-018-0819-0. Epub 2018 Feb 22.
We sought to determine the relationship between maternal mental illness and the risk of having an infant with a central nervous system defect. We analyzed a cohort of 654,882 women aged less than 20 years between 1989 and 2013 who later delivered a live born infant in any hospital in Quebec, Canada. The primary exposure was mental illness during pregnancy or hospitalization for mental illness before pregnancy. The outcomes were neural and non-neural tube defects of the central nervous system in any offspring. We computed risk ratios (RR) and 95% confidence intervals (CI) for the association between mental disorders and risk of central nervous system defects in log-binomial regression models adjusted for age at delivery, total parity, comorbidity, socioeconomic deprivation, place of residence, and time period. Maternal mental illness was associated with an increased risk of nervous system defects in offspring (RR 1.76, 95% CI 1.64-1.89). Hospitalization for any mental disorder was more strongly associated with non-neural tube (RR 1.84, 95% CI 1.71-1.99) than neural tube defects (RR 1.31, 95% CI 1.08-1.59). Women at greater risk of nervous system defects in offspring tended to be diagnosed with multiple mental disorders, have more than one hospitalization for mental disease, or be 17 or older at first hospitalization. A history of mental illness is associated with central nervous system defects in offspring. Women hospitalized for mental illness may merit counseling at first symptoms to prevent central nervous system defects at pregnancy.
我们旨在确定母亲精神疾病与婴儿中枢神经系统缺陷风险之间的关系。我们分析了 1989 年至 2013 年期间年龄小于 20 岁的 654882 名在加拿大魁北克省任何一家医院分娩活产婴儿的女性队列。主要暴露因素是怀孕或怀孕前住院期间的精神疾病。结果是任何后代的中枢神经系统神经和非神经管缺陷。我们在对数二项式回归模型中计算了精神障碍与中枢神经系统缺陷风险之间的关联的风险比（RR）和 95%置信区间（CI），调整了分娩时的年龄、总产次、合并症、社会经济剥夺、居住地和时间段。母亲精神疾病与后代神经系统缺陷风险增加相关（RR 1.76，95%CI 1.64-1.89）。任何精神障碍的住院治疗与非神经管缺陷（RR 1.84，95%CI 1.71-1.99）的相关性强于神经管缺陷（RR 1.31，95%CI 1.08-1.59）。后代神经系统缺陷风险较高的女性更有可能被诊断出患有多种精神障碍、有不止一次因精神疾病住院或在首次住院时年龄在 17 岁或以上。精神病史与后代中枢神经系统缺陷有关。因精神疾病住院的女性可能需要在首次出现症状时接受咨询，以预防怀孕期间的中枢神经系统缺陷。
