双相情感障碍的产前和围产期危险因素：一项系统评价和荟萃分析。
Prenatal and perinatal risk factors for bipolar disorder: A systematic review and meta-analysis.
作者信息
Shintani Augusto Ossamu, Rabelo-da-Ponte Francisco Diego, Marchionatti Lauro Estivalete, Watts Devon, Ferreira de Souza Fernando, Machado Cristiane Dos Santos, Pulice Rafaela Fernandes, Signori Giovanna Maiolli, Luzini Rafael Rocha, Kauer-Sant'Anna Márcia, Passos Ives Cavalcante
机构信息
Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) and Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul, School of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Porto Alegre, RS, Brazil.
Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) and Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul, School of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry, Porto Alegre, RS, Brazil; University of Central Lancashire, School of Pharmacy and Biomedical Sciences, Preston, United Kingdom.
出版信息
Neurosci Biobehav Rev. 2023 Jan;144:104960. doi: 10.1016/j.neubiorev.2022.104960. Epub 2022 Nov 12.
BACKGROUND
Perinatal and prenatal risk factors may be implicated in the development of bipolar disorder, but literature lacks a comprehensive account of possible associations.
METHODS
We performed a systematic review and meta-analyses of observational studies detailing the association between prenatal and perinatal risk factors and bipolar disorder in adulthood by searching PubMed, Embase, Web of Science and Psycinfo for articles published in any language between January 1st, 1960 and September 20th, 2021. Meta-analyses were performed when risk factors were available in at least two studies.
FINDINGS
Twenty seven studies were included with 18 prenatal or perinatal factors reported across the literature. Peripartum asphyxia (k = 5, OR = 1.46 [1.02; 2.11]), maternal stress during pregnancy (k = 2, OR = 12.00 [3.30; 43.59]), obstetric complications (k = 6, OR = 1.41 [1.18; 1.69]), and birth weight less than 2500 g (k = 5, OR = 1.28 [1.04; 1.56]) were associated with an increased risk for bipolar disorder.
INTERPRETATION
Perinatal and prenatal risk factors are implicated in the pathogenesis of bipolar disorder, supporting a role of prenatal care in preventing the condition.
背景
围产期和产前危险因素可能与双相情感障碍的发生有关，但文献中缺乏对可能关联的全面描述。
方法
我们通过检索PubMed、Embase、科学网和Psycinfo，对1960年1月1日至2021年9月20日期间以任何语言发表的文章进行系统综述和荟萃分析，详细研究产前和围产期危险因素与成年期双相情感障碍之间的关联。当至少两项研究中有危险因素数据时，进行荟萃分析。
结果
纳入了27项研究，文献中共报告了18种产前或围产期因素。产后窒息（k = 5，比值比 = 1.46 [1.02；2.11]）、孕期母亲应激（k = 2，比值比 = 12.00 [3.30；43.59]）、产科并发症（k = 6，比值比 = 1.41 [1.18；1.69]）以及出生体重低于2500克（k = 5，比值比 = 1.28 [1.04；1.56]）与双相情感障碍风险增加相关。
解读
围产期和产前危险因素与双相情感障碍的发病机制有关，支持产前护理在预防该病中的作用。
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