近几十年来,胃裂病在全球范围内有所增加,这种增加并没有被确定的风险因素解释。我们对加拿大出生的婴儿进行了一项基于人群的研究,2004-2020年。我们使用了“冬季”月份(即,9月至6月)和北部居住地作为阳光较少/不太活跃的生活方式的指标,而“夏天”(即,7月和8月)和南部地区被视为参考。冬季受孕婴儿的腹裂率(3.4/10,000)高于夏季受孕婴儿的腹裂率(2.2/10,000;p<0.001)。暴露在冬天,北部地区,甲状腺功能减退,物质或烟草使用和抑郁症最初被确定为腹裂的危险因素.<24岁的女性与2个月的受孕间隔之间存在显着的相互作用(比率(RR):1.42(95%置信区间[CI]1.19-1.70)。母亲抑郁(平均比率2.19,95%CI0.87-3.50,p=0.001)与婴儿腹裂的关系是由甲状腺功能减退介导的(平均比率1.04,95%CI1.01-1.07,p<0.001),而物质使用,甲状腺功能减退,吸烟和妊娠期糖尿病显示5.5-,3.1-,2.7-,和1.2倍协会,分别,母亲抑郁症。与夏季受孕间隔的低腹裂风险相反,腹裂的风险在其他十个月内与较高的压力适应水平相关,体温调节和新陈代谢,繁殖,和生长效应激素。我们的发现表明,甲状腺功能减退症介导的感知抑郁,可能在后代腹裂中起因果作用。
Gastroschisis has increased globally over recent decades, and this increase has not been explained by identified risk factors. We conducted a population-based study of infants born in Canada, 2004-2020. We used \"winter\" months (i.e., September through June) and northern areas of residence as indicators of less sunlight/less active lifestyle, while \"summer\" (i.e., July and August) and southern areas were considered as reference. Rate of
gastroschisis for infants conceived in winter (3.4 per 10,000) was higher than for infants conceived in summer (2.2 per 10,000; p < 0.001). Exposure to winter, and northern area, hypothyroidism, substance or tobacco uses and depressive disorder were initially identified as risk factors for gastroschisis. There was a significant interaction between women < 24 years of age and 2-month conception intervals (rate ratio (RR): 1.42 (95% confidence interval [CI] 1.19-1.70). The association of maternal depression (mean ratio 2.19, 95% CI 0.87-3.50, p = 0.001) with infant
gastroschisis was mediated by hypothyroidism (mean ratio 1.04, 95% CI 1.01-1.07, p < 0.001), whereas substance use, hypothyroidism, tobacco smoking and gestational diabetes showed 5.5-, 3.1-, 2.7-, and 1.2-fold associations, respectively, with maternal depression. In contrast to the summer conception interval of low
gastroschisis risk, an elevated risk of
gastroschisis spans the other ten months in association with higher levels of stress adaptation, thermoregulation and metabolism, reproduction, and growth effector hormones. Our findings suggest that periconception depression with mediation by hypothyroidism, may play a causal role in offspring
gastroschisis.