Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic, Barcelona, Spain.
Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic, Barcelona, Spain; Agusti Pi i Sunyer Biomedical Research Institute, Barcelona, Spain; Psychiatry Unit, Department of Medicine, University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain.
Biol Psychiatry Cogn Neurosci Neuroimaging. 2020 Dec;5(12):1077-1084. doi: 10.1016/j.bpsc.2020.07.018. Epub 2020 Aug 6.
Schizophrenia is a complex disorder in which clinical symptomatology typically reflects underlying brain abnormalities that coalign with multiple physical health comorbidities. The pathogenesis of schizophrenia involves the interplay between genetic and environmental factors, with obstetric complications widely described as key players in elevating the risk of psychosis. In this regard, understanding the anatomical and functional alterations associated with obstetric complications may help to elucidate potential mechanisms through which birth complications could contribute to schizophrenia pathogenesis. We conducted a systematic review of the extant literature describing brain abnormalities and obstetric complications in patients with schizophrenia and related disorders in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. A total of 471 studies were retrieved and screened, and 33 studies met inclusion criteria for our review. Studies varied considerably in their methods, with 11 studies employing computed tomography, 1 using magnetic resonance spectroscopy, and 21 using magnetic resonance imaging. The scientific quality of the included studies was assessed and documented. Obstetric complications increase the risk of provoking brain abnormalities. These abnormalities range from decreased gray matter volume and abnormal brain-ventricle ratios to a reduction of volume in limbic regions-which relate to what is commonly observed in schizophrenia. However, current evidence from neuroimaging studies remains scant in relation to establishing obstetric complications as an independent risk factor for schizophrenia.
精神分裂症是一种复杂的疾病，其临床症状通常反映了潜在的大脑异常，这些异常与多种身体健康合并症相一致。精神分裂症的发病机制涉及遗传和环境因素的相互作用，产科并发症被广泛描述为增加精神病风险的关键因素。在这方面，了解与产科并发症相关的解剖和功能改变可能有助于阐明出生并发症可能导致精神分裂症发病机制的潜在机制。我们按照 PRISMA（系统评价和荟萃分析的首选报告项目）指南，对描述精神分裂症和相关障碍患者大脑异常和产科并发症的现有文献进行了系统综述。共检索到 471 项研究，并进行了筛选，其中 33 项研究符合我们综述的纳入标准。这些研究在方法上差异很大，其中 11 项研究采用了计算机断层扫描，1 项研究采用了磁共振波谱，21 项研究采用了磁共振成像。我们对纳入研究的科学质量进行了评估和记录。产科并发症会增加引发大脑异常的风险。这些异常范围从灰质体积减少和脑-脑室比例异常到边缘区域体积减少，这些异常与精神分裂症中常见的情况有关。然而，目前神经影像学研究的证据仍然很少，无法确定产科并发症是精神分裂症的一个独立风险因素。
