产前母婴丧亡及其与子女智力残疾的关系。

Prenatal Maternal Bereavement and Its Association With Intellectual Disability in the Offspring.

机构信息

From the Clincial Research Centre, Shanghai First Maternity and Infant Hospital (Su), School of Medicine, Tongji University, China; Department of Clinical Medicine-Department of Clinical Epidemiology (Yu, Li), Aarhus University Hospital, Aarhus, Denmark; Department of Biostatistics, School of Public Health, and The Key Laboratory of Public Health Safety of Ministry of Education (Yu), Fudan University; Department of Obstetrics, Shanghai First Maternity and Infant Hospital (Meng, Duan), School of Medicine, Tongji University, Shanghai, China; Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital (Zhao), School of Medicine, Tongji University, Shanghai, China; Department of Public Health Sciences (László), Karolinska Institutet, Stockholm, Sweden; Centre for Public Health Sciences (Valdimarsdóttir), University of Iceland, Reykjavik, Iceland; Department of Medical Epidemiology and Biostatistics (Valdimarsdóttir), Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology (Valdimarsdóttir), Harvard TH Chan School of Public Health, Boston, Massachusetts; Department of Women & Children's Health Care, Shanghai First Maternity and Infant Hospital (Hua), School of Medicine, Tongji University; and Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital (Li), Shanghai Jiao Tong University School of Medicine, Shanghai, China.

出版信息

Psychosom Med. 2021 Oct 1;83(8):887-893. doi: 10.1097/PSY.0000000000000990.

DOI:10.1097/PSY.0000000000000990

PMID:34334730

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8505139/

Abstract

OBJECTIVE

This study aimed to examine the association of a mother's loss of a close relative before or during pregnancy with intellectual disability (ID) in the offspring.

METHODS

We performed a nationwide population-based cohort study based on Danish national registries. All live-born singletons born in Denmark during the 1978-2016 period (n = 2,216,601) were followed up starting from birth to 38 years of age. Log-linear Poisson regression was used to estimate the association between maternal bereavement (the death of an older child, a partner, or a parent 1 year before or during pregnancy) and the risk of ID in the offspring.

RESULTS

Maternal bereavement during or before pregnancy was associated with an increased risk of ID (incidence rate ratio [IRR] = 1.15; 95% confidence interval [CI] = 1.04-1.28). The risk of ID was increased by 27% when maternal bereavement occurred during pregnancy (IRR = 1.27; 95% CI = 1.08-1.49). When stratifying on the child's sex, we also observed an increased risk of ID associated with maternal bereavement during pregnancy both for male (IRR = 1.25; 95% CI = 1.02-1.53) and for female (IRR = 1.31; 95% CI = 1.02-1.69), respectively. The IRRs for unnatural death of a relative were also elevated (IRR = 1.22; 95% CI = 0.91-1.64) in general, although the difference was not statistically significant.

CONCLUSIONS

Our findings suggest that prenatal stress due to maternal loss of a close relative may increase the risk of offspring's ID of both sexes, in particular when the loss happened during pregnancy.

摘要

目的

本研究旨在探讨母亲在妊娠前或妊娠期间失去近亲与后代智力障碍（ID）的关系。

方法

我们进行了一项基于丹麦国家登记处的全国性人群队列研究。所有 1978 年至 2016 年期间在丹麦出生的活产单胎（n=2,216,601）从出生开始随访至 38 岁。采用对数线性泊松回归来估计母亲丧亲（妊娠前或妊娠期间 1 年失去年长子女、伴侣或父母）与后代 ID 风险之间的关系。

结果

母亲在妊娠期间或之前丧亲与 ID 风险增加相关（发病率比[IRR] = 1.15；95%置信区间[CI] = 1.04-1.28）。当母亲在妊娠期间丧亲时，ID 的风险增加了 27%（IRR = 1.27；95% CI = 1.08-1.49）。按孩子的性别分层时，我们还观察到母亲在妊娠期间丧亲与 ID 风险增加相关，无论是男性（IRR = 1.25；95% CI = 1.02-1.53）还是女性（IRR = 1.31；95% CI = 1.02-1.69）。一般来说，亲属非自然死亡的 IRR 也升高（IRR = 1.22；95% CI = 0.91-1.64），尽管差异无统计学意义。