作者：Laurie Barclay, MD 齣處：WebMD醫學新聞 　　January 7, 2009 — 一項發錶於一月號小兒醫學期刊的瑞典國傢世代研究結果顯示 早産與青少年或青年時期發生某些需 早産與之後發生精神疾病風險有關 - 趣味新聞網

發表日期 2009-01-20T06:26:03+08:00

     作者：Laurie Barclay, MD
齣處：WebMD醫學新聞

January 7, 2009 — 一項發錶於一月號小兒醫學期刊的瑞典國傢世代研究結果顯示，早産與青少年或青年時期發生某些需要住院的精神疾病有關。

瑞典斯德哥爾摩Karolinska機構的Karolina Lindstrom醫師與其同事錶示，越來越多早産兒存活到成人時期。過去的研究已經證實這些兒童發生神經與認知功能失能的程度增加。在這項研究中，我們分析早産對之後精神並存疾病的效應。

透過全國註冊研究，研究者們在1987年到2002年追蹤瑞典國傢世代共1973年到1979年之間齣生的兒童；因為精神疾病住院與酒精或物質濫用的危險比值以多變項Cox比例風險模式估計。

隨著早産的程度增加，因為精神疾病而住院的比例逐步增加；在24~48週時就齣生的早産兒，發生精神疾病而住院的比例為5.2%，而29~32週之間齣生的早産兒，因為精神疾病而住院的比例為3.5%。

在校正社經影響因子後，非常早産兒童（24~32週）發生精神異常的風險為1.68，中度早産兒童（33~36週）為1.21，早産兒童（37~38週）為1.08。中度早産與早産解釋瞭85%早産與提早生産相關的風險。齣生在低社經地位的傢庭，早産的效應更大。

這項研究的限製包括無法將這個發現推廣到更年輕的早産嬰兒世代、或是不是因為精神疾病而住院的病患；以及還可能有其他殘餘影響因子。

研究作者寫到，早産兒在青少年與青年時期（8~29歲）有因為精神疾病住院的某些風險；即使這個風險隨著早産程度增加，大部分個體是中度早産；這是一群確實需要更多研究與次級預防的族群。

Samariten基金會與瑞典勞動生活與社會研究會議贊助這項研究，這兩個組織都在斯德哥爾摩。研究作者們錶示沒有相關資金上的往來。

Preterm Birth Linked to Later Risk for Psychiatric Disorders

By Laurie Barclay, MD
Medscape Medical News

January 7, 2009 — Preterm birth is associated with some risk for psychiatric disorders requiring hospitalization in adolescence and young adulthood, according to the results of a Swedish national cohort study reported in the January issue of Pediatrics.

"Increasing numbers of infants born preterm survive into adulthood," write Karolina Lindstrom, MD, from Karolinska Institutet in Stockholm, Sweden, and colleagues. "Previous studies have reported increased levels of neurologic and cognitive disabilities in these children. In this study, we analyzed the effect of having been born preterm on psychiatric morbidity."

Using the national registers, the investigators followed up from 1987 to 2002 a Swedish national cohort of 545,628 individuals born between 1973 and 1979. Hazard ratios of hospital admissions for psychiatric disorders and alcohol or illicit drug abuse were estimated with use of multivariate Cox analysis of proportional hazards.

With an increasing degree of preterm birth, there was a stepwise increase in psychiatric hospital admissions. Hospitalization for a psychiatric disorder occurred in 5.2% of children born at 24 to 28?weeks' gestation and in 3.5% born at 29 to 32 weeks' gestation.

After adjustment for socioeconomic confounders, the hazard ratios for psychiatric disorders were 1.68 in the group of very preterm children (gestational weeks 24 - 32), 1.21 in the moderately preterm group (gestational weeks 33 - 36), and 1.08 in the early term group (gestational weeks 37 - 38). Moderately preterm and early term birth explained 85% of the risk associated with preterm or early term birth. In households with low socioeconomic status, there was a greater effect of preterm birth.

Limitations of the study include inability to generalize the findings to younger cohorts of preterm infants or to patients who were not hospitalized for psychiatric conditions; and possible residual confounding.

"Preterm birth carries some risk for psychiatric disorders requiring hospitalization in adolescence and young adulthood (ages 8–29 years)," the study authors write. "Even if this risk increases with degree of preterm birth, most subjects are moderately preterm, a group in need of more attention in research and secondary prevention."

The Samariten Foundation and the Swedish Council for Working Life and Social Research, both in Stockholm, supported this study. The study authors have disclosed no relevant financial relationships.

Pediatrics. 2009;123:e47-e53.

[ 本帖最後由 goodcat1111 於 2009-1-28 04:21 編輯 ]

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