Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.
ICES, Toronto, Ontario, Canada.
J Clin Psychiatry. 2023 Mar 1;84(2):22m14497. doi: 10.4088/JCP.22m14497.
To compare well-baby visit and vaccination schedule adherence up to age 24 months in children of mothers with versus without schizophrenia. Using administrative health data on births in Ontario, Canada (2012-2016), children of mothers with schizophrenia (: 295; : F20/F25; schizophrenia or schizoaffective disorder) (n = 1,275) were compared to children without maternal schizophrenia (n = 520,831) on (1) well-baby visit attendance, including an enhanced well-baby visit at age 18 months, and (2) vaccine schedule adherence for diphtheria, tetanus, pertussis, polio, type B (DTaP-IPV-Hib), and measles, mumps, rubella (MMR). Cox proportional hazard regression models were adjusted for each of maternal sociodemographics, maternal health, and child health characteristics in blocks and all together in a fully adjusted model. About 50.3% of children with maternal schizophrenia had an enhanced 18-month well-baby visit versus 58.6% of those without, corresponding to 29.0 versus 33.9 visits/100 person-years (PY), a hazard ratio (HR) of 0.82 (95% CI, 0.76-0.89). The association was dampened after adjustment for maternal sociodemographics, maternal health, and child health factors in blocks and overall, with a fully adjusted HR of 0.91 (95% CI, 0.84-0.98). Full vaccine schedule adherence occurred in 40.0% of children with maternal schizophrenia versus 46.0% of those without (22.6 vs 25.9/100 PY), yielding a HR of 0.86 (95% CI, 0.78-0.94). The association was dampened when adjusted for maternal sociodemographics and child health characteristics and became nonsignificant when adjusted for maternal health characteristics. The fully adjusted HR was 0.95 (95% CI, 0.87-1.04). Increased efforts to ensure that children with maternal schizophrenia receive key early preventive health care services are warranted.
比较母亲患有精神分裂症与无精神分裂症的儿童在 24 个月龄前的常规儿童保健就诊和疫苗接种情况。利用加拿大安大略省的出生登记数据（2012-2016 年），比较母亲患有精神分裂症（n=295；编码 F20/F25；精神分裂症或分裂情感性障碍）的儿童（n=1275）与母亲无精神分裂症（n=520831）的（1）常规儿童保健就诊情况，包括 18 月龄时的强化常规儿童保健就诊，以及（2）白喉、破伤风、无细胞百日咳、脊髓灰质炎、B 型流感嗜血杆菌（DTaP-IPV-Hib）和麻疹、腮腺炎、风疹（MMR）疫苗接种情况。使用 Cox 比例风险回归模型，根据母亲的社会人口统计学特征、母亲健康状况和儿童健康特征进行分层调整，并在完全调整模型中一起进行调整。约 50.3%的母亲患有精神分裂症的儿童接受了 18 月龄的强化常规儿童保健就诊，而母亲无精神分裂症的儿童这一比例为 58.6%，相应的就诊次数/100 人年为 29.0 次和 33.9 次，风险比（HR）为 0.82（95%可信区间，0.76-0.89）。调整了母亲的社会人口统计学特征、母亲健康状况和儿童健康因素的分层和总体因素后，这种关联减弱，完全调整后的 HR 为 0.91（95%可信区间，0.84-0.98）。母亲患有精神分裂症的儿童完全接种疫苗的比例为 40.0%，而母亲无精神分裂症的儿童为 46.0%（22.6 次和 25.9 次/100 人年），HR 为 0.86（95%可信区间，0.78-0.94）。调整了母亲的社会人口统计学特征和儿童健康特征后，这种关联减弱，调整了母亲健康特征后，关联不再具有统计学意义。完全调整后的 HR 为 0.95（95%可信区间，0.87-1.04）。有必要加大力度，确保患有精神分裂症的母亲的儿童获得关键的早期预防保健服务。
