Spry Elizabeth A, Wilson Claire A, Middleton Melissa, Moreno-Betancur Margarita, Doyle Lex W, Howard Louise M, Hannan Anthony J, Wlodek Mary E, Cheong Jeanie Ly, Hines Lindsey A, Coffey Carolyn, Brown Stephanie, Olsson Craig A, Patton George C
Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia.
Murdoch Children's Research Institute, Melbourne, Australia.
EClinicalMedicine. 2020 Oct 12;27:100564. doi: 10.1016/j.eclinm.2020.100564. eCollection 2020 Oct.
Preterm birth (PTB) and small for gestational age (SGA) are increasingly prevalent, with major consequences for health and development into later life. There is emerging evidence that some risk processes begin before pregnancy. We report on associations between maternal and paternal common mental disorders (CMD) before and during pregnancy and offspring PTB and SGA.
398 women with 609 infants and 267 men with 421 infants were assessed repeatedly for CMD symptoms before pregnancy between age 14 and 29 and during pregnancy. Associations between preconception and antenatal CMD symptoms and offspring gestational age/PTB and size for gestational age/SGA were estimated using linear and Poisson regression.
In men, persistent preconception CMD across adolescence and young adulthood predicted offspring PTB after adjustment for ethnicity, education, BMI and adolescent substance use (adjusted RR 7·0, 95% CI 1·8,26·8), corresponding to a population attributable fraction of 31% of preterm births. In women, antenatal CMD symptoms predicted offspring PTB (adjusted RR 4·4, 95% CI 1·4,14·1). There was little evidence of associations with SGA.
This first report of an association between paternal preconception mental health and offspring gestational age, while requiring replication in larger samples, complements earlier work on stress in animals, and further strengthens the case for expanding preconception mental health care to both men and women.
National Health and Medical Research Council (Australia), Victorian Health Promotion Foundation, Australian Rotary Health, Colonial Foundation, Perpetual Trustees, Financial Markets Foundation for Children (Australia), Royal Children's Hospital Foundation, Murdoch Children's Research Institute, Australian Research Council.
早产（PTB）和小于胎龄儿（SGA）越来越普遍，对健康及成年后的发育有重大影响。新出现的证据表明，一些风险过程在怀孕前就已开始。我们报告了怀孕前和怀孕期间父母常见精神障碍（CMD）与后代早产及小于胎龄儿之间的关联。
对398名有609名婴儿的女性和267名有421名婴儿的男性，在14至29岁怀孕前及怀孕期间反复评估CMD症状。使用线性回归和泊松回归估计孕前和产前CMD症状与后代胎龄/早产及胎龄大小/小于胎龄儿之间的关联。
在男性中，调整种族、教育程度、体重指数和青少年物质使用情况后，整个青春期和青年期持续存在的孕前CMD可预测后代早产（调整后相对危险度7.0，95%置信区间1.8,26.8），相当于早产人群归因分数的31%。在女性中，产前CMD症状可预测后代早产（调整后相对危险度4.4，95%置信区间1.4,14.1）。几乎没有证据表明与小于胎龄儿有关联。
这是关于父亲孕前心理健康与后代胎龄之间关联的首份报告，虽需在更大样本中重复验证，但补充了早期关于动物应激的研究工作，并进一步强化了将孕前心理健康护理扩展至男性和女性的理由。
澳大利亚国家卫生与医学研究委员会、维多利亚健康促进基金会、澳大利亚扶轮健康组织、殖民地基金会、永久受托人、澳大利亚儿童金融市场基金会、皇家儿童医院基金会、默多克儿童研究所、澳大利亚研究理事会。
