Larson Eric R, Karcher Nicole R, Moussa-Tooks Alexandra B
Department of Psychological & Brain Sciences, Indiana University, Bloomington, IN, USA.
Program in Neuroscience, Indiana University, Bloomington, IN, USA.
Schizophrenia (Heidelb). 2025 Aug 25;11(1):115. doi: 10.1038/s41537-025-00662-6.
Perinatal insults (e.g., obstetric complications, substance exposure) are increasing in prevalence and confer risk for psychotic-like experiences in offspring, contributing to a growing public health burden. Perinatal insults often co-occur, creating methodological challenges in understanding their impacts on psychosis-spectrum phenotypes. Data-driven approaches to organizing perinatal insults and testing their longitudinal effects on psychotic-like experiences in youth increases ecological validity and translational utility. Using data from 11,417 youth ages 9-14 across five years of the Adolescent Brain Cognitive Development (ABCD) Study, data-driven dimensions of perinatal insults were derived through exploratory factor analysis of thirty-one perinatal insults. Latent growth modeling tested the effect of perinatal insult dimensions on trajectories (baseline, rate-of-change, year-four severity) of distressing psychotic-like experiences. Six dimensions of perinatal insults were observed (substance exposure, obstetric complications, birth complications, postnatal challenges, parental age, medical needs). Substance exposure (β = 0.42, 95% CI [0.20, 0.63]), obstetric complications (β = 0.34, 95% CI [0.08, 0.61]), and parental age (β = 1.00, 95% CI [0.76, 1.22]) were associated with elevated baseline psychotic-like experiences. Perinatal insult dimensions were not associated with increasing rates-of-change in psychotic-like experiences. Medical needs (β = -0.12, 95% CI [-0.20, -0.05]) and parental age (β = -0.11, 95% CI [-0.18, -0.03]) were associated with steeper declines in psychotic-like experiences. Perinatal insult dimensions remained associated with elevated psychotic-like experiences at year-four. Data-driven dimensions of perinatal insults are associated with stably elevated psychotic-like experience trajectories across early adolescence. Given the role of psychotic-like experiences in later psychopathology and functioning, early identification of at-risk offspring is critical in reducing the public health burden of these exposures.
围产期损伤（如产科并发症、接触有害物质）的患病率正在上升，并使后代出现类精神病体验的风险增加，从而导致公共卫生负担日益加重。围产期损伤常常同时发生，这给理解它们对精神病谱系表型的影响带来了方法学上的挑战。采用数据驱动的方法来梳理围产期损伤，并测试它们对青少年类精神病体验的纵向影响，可提高生态效度和转化效用。利用青少年大脑认知发展（ABCD）研究五年间11417名9至14岁青少年的数据，通过对31种围产期损伤进行探索性因素分析，得出了围产期损伤的数据驱动维度。潜在增长模型测试了围产期损伤维度对令人痛苦的类精神病体验轨迹（基线、变化率、第四年严重程度）的影响。观察到围产期损伤的六个维度（接触有害物质、产科并发症、出生并发症、产后挑战、父母年龄、医疗需求）。接触有害物质（β = 0.42，95%可信区间[0.20, 0.63]）、产科并发症（β = 0.34，95%可信区间[0.08, 0.61]）和父母年龄（β = 1.00，95%可信区间[0.76, 1.22]）与较高的基线类精神病体验相关。围产期损伤维度与类精神病体验变化率的增加无关。医疗需求（β = -0.12，95%可信区间[-0.20, -0.05]）和父母年龄（β = -0.11，95%可信区间[-0.18, -0.03]）与类精神病体验更急剧的下降相关。围产期损伤维度在第四年时仍与较高的类精神病体验相关。围产期损伤的数据驱动维度与整个青春期早期类精神病体验轨迹持续升高相关。鉴于类精神病体验在后期精神病理学和功能中的作用，早期识别高危后代对于减轻这些暴露的公共卫生负担至关重要。
