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产科护理与成年后代的自杀倾向:病例对照研究

Obstetric care and proneness of offspring to suicide as adults: case-control study.

作者信息

Jacobson B, Bygdeman M

机构信息

Department of Medical Engineering, F60 Novum, Huddinge University Hospital, SE-141 86 Huddinge, Sweden.

出版信息

BMJ. 1998 Nov 14;317(7169):1346-9. doi: 10.1136/bmj.317.7169.1346.

Abstract

OBJECTIVE

To investigate any long term effects of traumatic birth and obstetric procedures in relation to suicide by violent means in offspring as adults.

DESIGN

Prospective case-control study.

SETTING

Stockholm, Sweden.

SUBJECTS

242 adults who committed suicide by violent means from 1978 to 1995, and who were born in one of seven hospitals in Stockholm during 1945-80, matched with 403 biological siblings born during the same period and at the same group of hospitals.

MAIN OUTCOME MEASURES

Adverse and beneficial perinatal factors expressed as relative risks (odds ratios) and 95% confidence intervals, derived from logistic regression of cases matched with their siblings.

RESULTS

For multiple birth trauma the estimated relative risks of offspring subsequently committing suicide by violent means were 4.9 (95% confidence interval 1.8 to 13) for men and 1.04 (0.2 to 4.6) for women. In mothers who received multiple opiate treatment during delivery, the estimated relative risk of offspring subsequently committing suicide was equal for both sexes (0.26, 0.09 to 0.69).

CONCLUSION

Minimising pain and discomfort to the infant during birth seems to be of importance in reducing the risk of committing suicide by violent means as an adult.

摘要

目的

调查创伤性分娩和产科手术对成年后代暴力自杀的长期影响。

设计

前瞻性病例对照研究。

地点

瑞典斯德哥尔摩。

研究对象

1978年至1995年间以暴力手段自杀的242名成年人,他们于1945年至1980年在斯德哥尔摩的七家医院之一出生,与同期在同一组医院出生的403名亲生兄弟姐妹配对。

主要观察指标

围产期不良和有益因素,以相对风险(比值比)和95%置信区间表示,通过病例与其兄弟姐妹匹配后的逻辑回归得出。

结果

对于多次分娩创伤,后代随后以暴力手段自杀的估计相对风险,男性为4.9(95%置信区间1.8至13),女性为1.04(0.2至4.6)。在分娩期间接受多次阿片类药物治疗的母亲中,后代随后自杀的估计相对风险在两性中相等(0.26,0.09至0.69)。

结论

在出生时尽量减少婴儿的疼痛和不适,对于降低成年后暴力自杀的风险似乎很重要。

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