Verdoux H, Geddes J R, Takei N, Lawrie S M, Bovet P, Eagles J M, Heun R, McCreadie R G, McNeil T F, O'Callaghan E, Stöber G, Willinger M U, Wright P, Murray R M
Department of Psychiatry, Université Victor Segalen Bordeaux 2, France.
Am J Psychiatry. 1997 Sep;154(9):1220-7. doi: 10.1176/ajp.154.9.1220.
An excess of obstetric complications in the histories of schizophrenic patients is a well-replicated finding, but less consistent results have been found concerning the relationships between obstetric complications and family history of schizophrenia, age at onset of schizophrenia, and gender. Small sample size limited the power of previous studies that attempted to assess such relationships. The aim of this study was to use data on individual patients from all available studies to examine the links between a history of obstetric complications and family history of schizophrenia, age at onset, and gender.
Raw data from 854 schizophrenic patients concerning history of obstetric complications rated according to the Lewis and Murray scale were obtained from 11 different research groups. Weighted average estimates were calculated with the use of regression techniques.
A significant association was found between age at onset of schizophrenia and obstetric complications: the earlier the age at onset, the more likely the history of obstetric complications. Subjects with onset of schizophrenia before age 22 were 2.7 times more likely than those with onset at a later age to have had a history of abnormal presentation at birth and 10 times more likely to have had a history of complicated Cesarean birth. No association was found between obstetric complications and family history of schizophrenia or gender.
The association between obstetric complications and early age at onset of schizophrenia indicates that the pathophysiology of early-onset schizophrenia involves neurodevelopmental impairment.
精神分裂症患者病史中产科并发症过多是一项已被充分重复验证的发现，但关于产科并发症与精神分裂症家族史、精神分裂症起病年龄及性别之间的关系，研究结果却不太一致。样本量较小限制了以往试图评估此类关系的研究的效力。本研究的目的是利用所有现有研究中个体患者的数据，来检验产科并发症史与精神分裂症家族史、起病年龄及性别之间的联系。
从11个不同的研究小组获取了854例精神分裂症患者根据刘易斯和默里量表评定的产科并发症史的原始数据。使用回归技术计算加权平均估计值。
发现精神分裂症起病年龄与产科并发症之间存在显著关联：起病年龄越早，产科并发症史的可能性越大。22岁前起病的精神分裂症患者出生时胎位异常史的可能性是起病较晚者的2.7倍，剖宫产史的可能性是起病较晚者的10倍。未发现产科并发症与精神分裂症家族史或性别之间存在关联。
产科并发症与精神分裂症早发之间的关联表明，早发性精神分裂症的病理生理学涉及神经发育损害。
