School of Psychiatry, University of New South Wales, Sydney, NSW, Australia; Neuroscience Research Australia, Sydney, NSW, Australia.
School of Psychiatry, University of New South Wales, Sydney, NSW, Australia; Neuroscience Research Australia, Sydney, NSW, Australia.
Brain Behav Immun. 2021 Oct;97:376-382. doi: 10.1016/j.bbi.2021.08.009. Epub 2021 Aug 11.
Early life exposure to infectious diseases confers risk for adult psychiatric disorders but relatively few human population studies have examined associations with childhood mental disorder. Here we examined the effects of exposure to maternal infection during pregnancy, and child infectious diseases in early childhood (birth to age 4 years), in relation to first mental disorder diagnosis (age 5-13 years). The study sample comprised 71,841 children represented in a population cohort of children in New South Wales, Australia, followed from birth to early adolescence via linkage of administrative registers. Childhood exposure to infectious disease was determined during the prenatal period (i.e., maternal infection during gestation), and in early childhood (between birth and age 4 years) using the NSW Ministry of Health Admitted Patients data collection. Days to first diagnosis with a mental disorder was determined from recorded diagnoses between age 5-13 years in the NSW Ministry of Health's Admitted Patients, Emergency Department and Mental Health Ambulatory data collections. While crude hazard ratios for both prenatal infection and childhood infection exposures indicated significantly earlier diagnosis with mental disorders associated with both of these risk factors, only childhood infection exposure was associated with higher adjusted hazard ratios (aHR) for any diagnoses (aHR = 1.21, 95% CI = 1.11-1.32), externalising disorders (aHR = 1.45, 95% CI 1.18-1.79) and developmental disorders (aHR = 1.82, 95% CI 1.49-2.22) when the effects of maternal and early childhood (age < 5 years) mental disorders were taken into account. Exposure to infectious diseases during early childhood, but not prenatal infection exposure, appears to be associated with earlier diagnosis of mental disorders in childhood.
早年暴露于传染病会增加成年后精神障碍的风险，但很少有人群研究探讨过儿童精神障碍与传染病的关联。在这里，我们研究了母亲怀孕期间感染以及儿童在幼儿期（出生到 4 岁）暴露于传染病与首次精神障碍诊断（5-13 岁）之间的关系。研究样本包括澳大利亚新南威尔士州的一个人群队列中的 71841 名儿童，通过行政登记的链接从出生到青少年早期进行随访。儿童期传染病暴露是通过 NSW 卫生部入院患者数据收集在产前（即妊娠期间的母亲感染）和幼儿期（出生到 4 岁之间）确定的。首次诊断为精神障碍的天数是根据 NSW 卫生部入院患者、急诊科和心理健康门诊数据收集记录的 5-13 岁之间的诊断来确定的。虽然产前感染和儿童期感染暴露的粗危险比均表明与这两个危险因素相关的精神障碍的诊断明显更早，但只有儿童期感染暴露与更高的调整后危险比（aHR）相关任何诊断（aHR=1.21，95%CI=1.11-1.32）、外化障碍（aHR=1.45，95%CI 1.18-1.79）和发育障碍（aHR=1.82，95%CI 1.49-2.22），当考虑到母亲和幼儿期（<5 岁）精神障碍的影响时。儿童期暴露于传染病，而不是产前感染暴露，似乎与儿童期精神障碍的早期诊断有关。
