Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom.
Administrative Data Research Centre-Northern Ireland, Queen's University Belfast, Institute of Clinical Sciences B Royal Hospitals Site, Belfast, United Kingdom.
JAMA Psychiatry. 2018 May 1;75(5):438-446. doi: 10.1001/jamapsychiatry.2018.0133.
Approximately 1 in 10 children worldwide are born to consanguineous parents. The literature on consanguinity and mental health of progeny is scarce despite the fact that many of the factors associated with consanguineous unions are also associated with mental health.
To investigate if children of consanguineous parents are at increased risk of common mood disorders or psychoses.
DESIGN, SETTING, AND PARTICIPANTS: This investigation was a retrospective population-wide cohort study of all individuals born in Northern Ireland between January 1, 1971, and December 31, 1986, derived from the Child Health System data set and linked to nationwide administrative data sources on prescription medication and death records. Data from the Child Health System data set identified all 447 452 births delivered to mothers residing in Northern Ireland between 1971 and 1986. The final data set comprised 363 960 individuals, alive and residing in Northern Ireland in 2014, with full data on all variables. The dates of analysis were June 1 to October 31, 2017.
Degree of parental consanguinity was assessed from questions asked of the parents during routine health visitor house calls within 2 weeks of the child's birth. Potential mental ill health was estimated by receipt of psychotropic medication in 2010 to 2014. Ever or never use was used for the main analysis, with sensitivity analyses using a cutoff of at least 3 months' prescriptions. Receipt of antidepressant or anxiolytic medications was used as a proxy for common mood disorders, whereas receipt of antipsychotic medications was used as a proxy indicator of psychoses.
Of the 363 960 individuals (52.5% [191 102] male), 609 (0.2%) were born to consanguineous parents. After full adjustment for factors known to be associated with poor mental health, multilevel logistic regression models found that children of first-cousin consanguineous parents were more than 3 times as likely to be in receipt of antidepressant or anxiolytic medications (odds ratio, 3.01; 95% CI, 1.24-7.31) and more than twice as likely to be in receipt of antipsychotic medication (odds ratio, 2.13; 95% CI, 1.29-3.51) compared with children of nonrelated parents.
A child of consanguineous parents is at increased risk of common mood disorders and psychoses.
全世界大约有十分之一的儿童是近亲所生。尽管与近亲结婚有关的许多因素也与心理健康有关，但有关近亲结婚和后代心理健康的文献却很少。
调查父母为近亲的儿童是否更容易患常见的情绪障碍或精神病。
设计、地点和参与者：这是一项回顾性的全人群队列研究，纳入了 1971 年 1 月 1 日至 1986 年 12 月 31 日期间在北爱尔兰出生的所有个体，数据来源于儿童健康系统数据集，并与全国处方药物和死亡记录的行政数据源相链接。儿童健康系统数据集的数据确定了 1971 年至 1986 年期间居住在北爱尔兰的母亲所生的 447452 例分娩。最终数据集包括 363960 名在 2014 年仍在世并居住在北爱尔兰的个体，所有变量都有完整的数据。分析日期为 2017 年 6 月 1 日至 10 月 31 日。
通过在孩子出生后两周内由家庭健康访问员家访时询问父母来评估父母的近亲程度。通过 2010 年至 2014 年期间接受精神药物治疗来估计潜在的心理健康问题。主要分析采用了“使用或未使用”的方法，对至少 3 个月的处方进行了敏感性分析。使用抗抑郁药或抗焦虑药物的使用作为常见情绪障碍的替代指标，而使用抗精神病药物的使用作为精神病的替代指标。
在 363960 名个体（52.5%[191102]为男性）中，有 609 名（0.2%）出生于近亲结婚的家庭。在充分调整了已知与不良心理健康相关的因素后，多水平逻辑回归模型发现，与非近亲父母所生的儿童相比，第一代表亲近亲结婚所生的儿童更有可能服用抗抑郁药或抗焦虑药物（比值比，3.01；95%CI，1.24-7.31），也更有可能服用抗精神病药物（比值比，2.13；95%CI，1.29-3.51）。
父母为近亲的儿童患常见情绪障碍和精神病的风险增加。
