早产儿患精神疾病的风险可能更大

1、早产儿患精神疾病的风险可能更大小杨 发表于  2012-07-09 20:55有研究者发现，早产可能会增加人们青春期和成年时期患上严重心理疾病的风险。研究人员对出生在1973年到1985年间的130多万名瑞典人的出生及住院记录进行了回顾。他们发现，那些妊娠期低于32周的婴儿在他们成年后，他们因精神分裂症或妄想症而住院的几率要比与正常出生的人高出2倍多，患严重抑郁症的几率要高近3倍，患躁郁症的几率则高7倍多。此外，那些妊娠期在32到36周晚期早产的婴儿同样有着此类风险，只是不那么严重而已。他们患上以上疾病的几率分别是正常人的1.6、1.34和2倍。研究人员表示，该发现受到了一

2、些不可控因素的影响，其中包括不可测量的社会人口因素、早产家族史、产妇药物滥用或吸烟，以及细菌或病毒感染。但是那些未参与此研究的专家仍对该发现留下了深刻的印象。美国哥伦比亚大学研究围产期和神经科学的临床心理学副教授凯瑟琳蒙克（Catherine Monk）觉得“这是一项十分重要的流行病学研究。它为人类心理健康初始于早期发育的说法提供了强有力的证据”。即便如此，论文主要作者、英国伦敦国王学院的高级讲师卢嘉勒诺莎蒂（Chiara Nosarti）依然强调，早产带来的相对风险虽然很大，但患病者的绝对增长数并非如此。诺莎蒂说：“绝大多数早产的人都没有精神上的问题，并且因精神病而住院的人数也十分地少。但是

3、，例行检查仍是发现疾病早期征兆的好办法。”蒙克也表示，该研究结果并不意味着早产势必就会导致精神疾病，“在绝对意义上，该风险仍然很低，况且它还受到很多儿童发育时期的其他因素影响。”哥伦比亚大学纽约州精神病研究所发育神经精神科中心主任布拉德利彼得森（Bradley Peterson）表示，该研究的样本大小“十分惊人”，并且“该发现的真实性也非常之高”。对于这一研究，作者们给出了一个可能的生理学解释。他们认为早产儿的大脑后续特别容易受到伤害，并且功能性磁共振成像发现，早产的成年人的大脑网络紊乱情况与精神病患者的脑部情况相似。此外，一些遗传因素也可能因为早产而被激活。该 研究 发布

4、在了普通精神病学文献（Archives of General Psychiatry）6月刊上，它使用了瑞典医学出生登记处的产科数据进行研究，该数据涵盖了1973年来瑞典超过99%的医院出生记录，以及95%的妇女产前检查信息。本文编译自:nytimes. Early Birth May Pose Higher Risk to the Mind图片:University of AdelaideEarly Birth May Pose Higher Risk to the Mind Premature birth may increase the risk for serious mental il

5、lness in adolescence and young adulthood, a recent study reports.最近一项研究发现，早产可能会增加个体在青春期和成年早期患精神疾病的几率。Researchers reviewed birth and hospital admissions records of more than 1.3 million Swedes born from 1973 to 1985. They found that compared with those born at term, young adults born very premature a

6、t less than 32 weeks gestation were more than twice as likely to be hospitalized for schizophrenia or delusional disorders, almost three times as likely for major depression, and more than seven times as likely for bipolar illness.研究人员查阅了出生于1973年至1985年间的130万瑞典人出生和医院入院记录。他们发现，过早出生的年轻人不足32周妊娠期就出生，患精神分

7、裂症、妄想症的几率是那些足月出生的人的两倍，患抑郁症的几率差不多是足月出生人的三倍，而患躁郁症的几率则是足月出生人的七倍多。The lead author, Chiara Nosarti, a senior lecturer in neuroimaging at Kings College London, emphasized that while the increase in relative risk is substantial, the absolute increase in numbers of people with the illnesses is not.该研究的主要负责人

8、，奇亚拉?诺莎提，是伦敦国王学院神经成像学的高级讲师。她强调说，虽然患病相对几率的增加是实质性的，但患病人数的绝对增加却并不是。“Despite these findings,” she said, “the majority of people born preterm have no psychiatric problems, and the number of people hospitalized with psychiatric disease is very low.”“尽管有着这样的调查结果，”她说，“但其实大部分早产的人并没有精神疾病，因精神疾病入院就医的人也很少。”Still

9、, she added, “routine screening may help to detect early signs of illness.”但是，她又说道：“例行的检查能够帮助发现疾病的早期症状。”The risk also increased for people born late preterm, or 32 to 36 weeks gestation, but not as sharply. They were 60 percent more likely to be admitted for schizophrenia or delusional disorders, 34

10、 percent more likely for depressive disorder, and about twice as likely to be hospitalized for bipolar illness.晚期早产儿，也就是经过32到36周的妊娠期出生的，患病几率也会增加，但不像早期早产儿那么明显。他们患精神分裂症或妄想症的几率比足月出生的要高60%，患抑郁症的几率高34%，而患躁郁症的几率是那些足月出生的2倍。The researchers acknowledge that the findings could be affected by factors they coul

11、d not control for, including unmeasured sociodemographic factors, a family history of preterm delivery, maternal substance abuse or smoking, and bacterial or viral infections.研究者们也承认调查结果可能会受一些非可控因素的影响，包括不可测量的社会人口因素，早产的家族历史，产妇药物滥用，抽烟以及细菌或是病毒性感染。But experts not involved in the study were impressed wit

12、h the work. “This is an important, expertly executed epidemiological study,” said Catherine Monk, an associate professor of clinical psychology at Columbia who conducts research in perinatal psychiatry and neuroscience. “It provides compelling evidence that our mental health trajectories are initiat

13、ed early in development.”但那些并没参与这项研究的专家们则是对这份研究印象深刻。“这是一项重要的、成熟的流行病学的研究。”哥伦比亚大学研究围产期精神病学和神经科学的临床心理学副教授凯瑟琳?蒙克说道，“这项研究提供了大量的证据，证明了我们的心理健康轨迹开始于人最初的发展阶段。”Dr. Monk, too, noted that the study did not mean that being born prematurely inevitably leads to mental illness.蒙克博士也注意到，这项研究并不意味着过早的出生一定不可避免地会导致精神疾病。

14、“The risk found is still low in an absolute sense, and finally it, too, can be modified by other factors in the childs development,” she said.“从绝对意义上来讲，患病几率仍然是很小，并且，患病几率也能被个体儿童时期发展中的其他因素所改变。”Dr. Bradley Peterson, director of the Center for Developmental Neuropsychiatry at the New York State Psychiat

15、ric Institute, said the size of the sample was “stunning” and “allows very strong levels of confidence that the findings are not spurious.”纽约州精神病学研究所发展神经精神病学中心主任布兰得利?彼得森博士指出该项研究的研究对象的数目“惊人”，“在很大程度上让人们相信这项研究的调查结果是真实可靠的。”The studys authors said there was a plausible biological explanation for their fi

16、nding. The preterm brain is particularly vulnerable to injury, and functional M.R.I. imaging of young adults born very preterm has found disruptions in brain networks similar to those found in psychiatric patients. In addition, genetic factors that would not by themselves lead to illness could be ac

17、tivated by preterm birth.该研究的研究者们还指出他们的调查结果有合理的生物学解释。早产儿的大脑易受到伤害，并且他们在那些过早出生的早产儿的功能性核磁共振成像中发现了脑网络的紊乱，这些紊乱与精神病人的脑紊乱相似。除此之外，那些独自不会导致疾病的基因可能会被早产激活。Dr. Peterson agreed that the study offered strong evidence “for a causative relationship rather than simply an association.”彼得森博士也认为这份研究提供了非常有力的证据来证明“早产与精神疾

18、病之间的关系是因果关系，而不是简单的联系。”The study, published online last month in Archives of General Psychiatry, used obstetric data from the Swedish Medical Birth Register, which includes information on more than 99 percent of all hospital births in the country since 1973 and contains prospectively collected inform

19、ation on the 95 percent of Swedish women who attend antenatal clinics.这份研究报告上个月在普通精神病学文献的网上发布，该研究使用了瑞典出生登记的产科数据。这些数据包括了瑞典1973年以来99%以上医院出生个体的信息以及95%的做过产前诊断的瑞典产妇的相关信息。The data on hospitalization came from the National Hospital Discharge Register, which contains records on all hospital diagnoses. The researchers connected the birth records to hospitalization data using the personal identification numbers assigned to all Swedish citizens.有关住院治疗的数据来自于国立医院出院登记处，包括所有医院诊断的记录。研究人员通过每个瑞典公民都有的个人身份识别号码将出生记录和住院治疗数据连接起来。The scientists considered two other pregnancy out