Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, Woodstock Road, University of Oxford, OX2 6GG, UK.
Weill Institute for Neurosciences, School of Medicine, The University of California, San Francisco, 401, Parnassus Ave, San Francisco, CA, 94143, USA.
J Psychiatr Res. 2021 Jul;139:125-131. doi: 10.1016/j.jpsychires.2021.05.039. Epub 2021 May 23.
Maternal infection is thought to increase the risk of non-affective psychosis including schizophrenia. However, observational studies have produced conflicting results and little is known about the importance of timing of infection in mediating subsequent risk. In this study, we carried out a meta-analysis of observational studies to investigate the risk of maternal infection and subsequent risk of non-affective psychosis. Using seven cohort studies, we found that maternal infection during gestation increased the risk of non-affective psychosis [relative risk (RR): 1.28 (95% CI:1.05-1.57, p = 0.02, I = 36%)]. A subgroup analysis identified that there was greater risk for schizophrenia alone [RR: 1.65 (95% CI:1.23-2.22, p = 0.0008, I = 0%)]. In addition, infection during the second trimester resulted in increased risk [RR: 1.63 (95% CI:1.07-2.48, p = 0.02, I = 7%)], whilst risk during the first and third trimesters did not meet statistical significance. This study highlights maternal infection in gestation as an important environmental risk factor for non-affective psychosis and our findings carry important implications for future disease prevention strategies.
母体感染被认为会增加非情感性精神病(包括精神分裂症)的风险。然而,观察性研究得出了相互矛盾的结果,对于感染在介导随后的风险中的重要性知之甚少。在这项研究中,我们对观察性研究进行了荟萃分析,以调查母体感染与随后发生非情感性精神病的风险。我们使用了 7 项队列研究,发现妊娠期间的母体感染增加了非情感性精神病的风险[相对风险(RR):1.28(95%可信区间:1.05-1.57,p=0.02,I=36%)]。亚组分析表明,单独的精神分裂症风险更高[RR:1.65(95%可信区间:1.23-2.22,p=0.0008,I=0%)]。此外,妊娠中期的感染导致风险增加[RR:1.63(95%可信区间:1.07-2.48,p=0.02,I=7%)],而第一和第三孕期的感染风险则没有达到统计学意义。本研究强调妊娠期间的母体感染是非情感性精神病的一个重要环境风险因素,我们的研究结果对未来的疾病预防策略具有重要意义。