Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland.
Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh EH10 5HF, UK.
Psychol Med. 2024 Jul;54(9):2087-2098. doi: 10.1017/S0033291724000187. Epub 2024 Mar 4.
Prenatal and perinatal complications are established risk factors for psychotic disorder, but far less is known about these measures and psychotic experiences (PEs). We investigated the longitudinal effect of prenatal risk factors (maternal behavior, medication complications) and perinatal risk factors (birth weight, medical complications) on frequency of PEs. We also examined the cumulative risk of prenatal/perinatal risk factors, and differences between transient PE, persistent PE, and controls.
The Adolescent Brain Cognitive Development study is a large child cohort (age 9-10 at baseline; = 11 872 with PE data). PEs were measured longitudinally using the Prodromal Questionnaire-Brief, Child version, and included only if reported as distressing. Mixed-effects models were used for analysis, controlling for random effects, and a substantial number of fixed-effects covariates.
Urinary tract infection ( = 0.11, 95% confidence interval [CI] 0.03-0.19) and severe anemia ( = 0.18, 95% CI 0.07-0.29) increased frequency of distressing PEs in childhood. Number of prenatal complications increased frequency of PEs ( = 0.03, 95% CI 0.01-0.06) and risk of persistent PEs (odds ratio [OR] = 1.08, 95% CI 1.01-1.15). Maternal smoking was associated with an increased frequency of PEs ( = 0.11, 95% CI 0.04-0.18) and persistent PEs (OR = 1.31, 95% CI 1.04-1.66). Maternal substance use was a risk factor for a 48% increased risk of persistent PEs (OR = 1.48, 95% CI 1.08-2.01). Perinatal complications showed no effect on PEs.
This study provides evidence that certain prenatal medical complications (severe nausea, severe anemia), cumulative number of prenatal medical complications, and maternal behaviors (smoking during pregnancy), increased frequency of distressing PEs in childhood. Maternal smoking and substance use, as well as cumulative number of prenatal complications increased risk of persistent PEs.
产前和围产期并发症是精神障碍的既定风险因素，但对于这些因素和精神病体验（PEs）的了解要少得多。我们研究了产前风险因素（母亲行为、药物并发症）和围产期风险因素（出生体重、医疗并发症）对 PEs 频率的纵向影响。我们还检查了产前/围产期风险因素的累积风险，以及短暂性 PE、持续性 PE 和对照组之间的差异。
青少年大脑认知发展研究是一项大型儿童队列研究（基线时年龄为 9-10 岁；共有 11872 名具有 PE 数据的参与者）。使用前驱症状问卷-简短版，儿童版，对 PEs 进行纵向测量，仅在报告为困扰时才包括在内。使用混合效应模型进行分析，控制随机效应和大量固定效应协变量。
尿路感染（ = 0.11，95%置信区间 [CI] 0.03-0.19）和严重贫血（ = 0.18，95% CI 0.07-0.29）增加了儿童时期困扰性 PE 的频率。产前并发症数量增加了 PEs 的频率（ = 0.03，95% CI 0.01-0.06）和持续性 PEs 的风险（比值比 [OR] = 1.08，95% CI 1.01-1.15）。母亲吸烟与 PEs 频率增加（ = 0.11，95% CI 0.04-0.18）和持续性 PEs （OR = 1.31，95% CI 1.04-1.66）有关。母亲物质使用是持续性 PEs 风险增加 48%的危险因素（OR = 1.48，95% CI 1.08-2.01）。围产期并发症对 PEs 没有影响。
这项研究提供了证据表明，某些产前医疗并发症（严重恶心、严重贫血）、产前医疗并发症的累积数量以及母亲行为（怀孕期间吸烟）增加了儿童时期困扰性 PEs 的频率。母亲吸烟和物质使用以及产前并发症的累积数量增加了持续性 PEs 的风险。
