Vigod Simone N, Ray Joel G, Cohen Eyal, Wilton Andrew S, Saunders Natasha R, Barker Lucy C, Berard Anick, Dennis Cindy-Lee, Holloway Alison C, Morrison Katherine, Oberlander Tim F, Hanley Gillian, Tu Karen, Brown Hilary K
Women's College Hospital and Women's College Research Institute, Toronto, ON, Canada.
Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Schizophr Bull. 2022 Nov 18;48(6):1252-1262. doi: 10.1093/schbul/sbac091.
Maternal schizophrenia heightens the risk for certain perinatal complications, yet it is not known to what degree future childhood chronic health conditions (Childhood-CC) might arise.
This population-based cohort study using health administrative data from Ontario, Canada (1995-2018) compared 5066 children of mothers with schizophrenia to 25 324 children of mothers without schizophrenia, propensity-matched on birth-year, maternal age, parity, immigrant status, income, region of residence, and maternal medical and psychiatric conditions other than schizophrenia. Cox proportional hazard models generated hazard ratios (HR) and 95% confidence intervals (CI) for incident Childhood-CCs, and all-cause mortality, up to age 19 years.
Six hundred and fifty-six children exposed to maternal schizophrenia developed a Childhood-CC (20.5/1000 person-years) vs. 2872 unexposed children (17.1/1000 person-years)-an HR of 1.18, 95% CI 1.08-1.28. Corresponding rates were 3.3 vs. 1.9/1000 person-years (1.77, 1.44-2.18) for mental health Childhood-CC, and 18.0 vs. 15.7/1000 person-years (1.13, 1.04-1.24) for non-mental health Childhood-CC. All-cause mortality rates were 1.2 vs. 0.8/1000 person-years (1.34, 0.96-1.89). Risk for children exposed to maternal schizophrenia was similar whether or not children were discharged to social service care. From age 1 year, risk was greater for children whose mothers were diagnosed with schizophrenia prior to pregnancy than for children whose mothers were diagnosed with schizophrenia postnatally.
A child exposed to maternal schizophrenia is at elevated risk of chronic health conditions including mental and physical subtypes. Future research should examine what explains the increased risk particularly for physical health conditions, and what preventive and treatment efforts are needed for these children.
母亲患有精神分裂症会增加某些围产期并发症的风险，但尚不清楚未来儿童慢性健康状况（Childhood-CC）会在何种程度上出现。
这项基于人群的队列研究使用了加拿大安大略省的卫生行政数据（1995 - 2018年），将5066名患有精神分裂症母亲的子女与25324名未患精神分裂症母亲的子女进行比较，根据出生年份、母亲年龄、产次、移民身份、收入、居住地区以及除精神分裂症外的母亲医疗和精神疾病状况进行倾向匹配。Cox比例风险模型生成了19岁之前发生Childhood-CC和全因死亡率的风险比（HR）及95%置信区间（CI）。
656名暴露于母亲精神分裂症的儿童出现了Childhood-CC（20.5/1000人年），而2872名未暴露儿童为（17.1/1000人年），风险比为1.18，95%置信区间为1.08 - 1.28。心理健康方面的Childhood-CC相应发生率分别为3.3/1000人年和1.9/1000人年（1.77，1.44 - 2.18），非心理健康方面的Childhood-CC相应发生率分别为18.0/1000人年和15.7/1000人年（1.13，1.04 - 1.24）。全因死亡率分别为1.2/1000人年和0.8/1000人年（1.34，0.96 - 1.89）。无论儿童是否被转至社会服务机构照料，暴露于母亲精神分裂症的儿童的风险相似。从1岁起，母亲在怀孕前被诊断为精神分裂症的儿童的风险高于母亲在产后被诊断为精神分裂症的儿童。
暴露于母亲精神分裂症的儿童患慢性健康状况（包括精神和身体亚型）的风险升高。未来的研究应探讨是什么导致了这种风险增加，尤其是身体健康状况方面的风险增加，以及这些儿童需要哪些预防和治疗措施。
