母亲精神分裂症与出生时后代的并发症有关。儿童患有复杂慢性疾病(CCC)的未来风险是否更高,这是一种影响任何身体系统的儿科疾病,预计持续至少12个月,其严重程度足以需要特殊护理和/或住院时间-未知。
在这项基于人群的卫生行政数据队列研究中(安大略省,加拿大,1995-2018),在5066名精神分裂症妇女(暴露者)的儿童中比较了CCC的风险。2,939,320名未暴露儿童。针对任何CCC的发生生成调整后的危险比(AHR),按CCC类别,按儿童性别分层,和孩子早产。
CCC在暴露者中(7.7/1000人年[268名儿童])比未暴露者(4.2/100人年[124,452名儿童])更频繁-aHR为1.25(95%CI1.10-1.41)。在9个CCC类别中的5个中,aHR明显较高:神经肌肉(1.73,1.28-2.33),心血管(1.94,1.64-2.29),呼吸(1.83,1.32-2.54),血液学/免疫缺陷(2.24,1.24-4.05)和其他先天性或遗传性缺陷(1.59,1.16-2.17)。CCC的aHR在男孩(1.32,1.13-1.55)中比女孩(1.16,0.96-1.40)更明显,足月婴儿(1.22,1.05-1.42)和早产儿(1.18,0.95-1.46)的幅度相似。
精神分裂症女性所生的孩子患CCC的风险似乎更高。这一发现为有针对性的孕前咨询提供了机会,优化孕产妇危险因素,和干预措施,以支持脆弱的父母群体,他们将面临独特的挑战,照顾有CCC的孩子。
Maternal schizophrenia is linked to complications in offspring near the time of birth. Whether there is also a higher future risk of the child having a complex chronic condition (CCC) - a pediatric condition affecting any bodily system expected to last at least 12 months that is severe enough to require specialty care and/or a period of hospitalization - is not known.
In this population-based health administrative data cohort study (Ontario, Canada, 1995-2018), the risk for CCC was compared in 5066 children of women with schizophrenia (the exposed) vs. 2,939,320 unexposed children. Adjusted hazard ratios (aHR) were generated for occurrence of any CCC, by CCC category, and stratified by child sex, and child prematurity.
CCC was more frequent in the exposed (7.7 per 1000 person-years [268 children]) than unexposed (4.2 per 100 person-years [124,452 children]) - an aHR of 1.25 (95% CI 1.10-1.41). aHRs were notably higher in 5 of 9 CCC categories: neuromuscular (1.73, 1.28-2.33), cardiovascular (1.94, 1.64-2.29), respiratory (1.83, 1.32-2.54), hematology/immunodeficiency (2.24, 1.24-4.05) and other congenital or genetic defect (1.59, 1.16-2.17). The aHR for CCC was more pronounced among boys (1.32, 1.13-1.55) than girls (1.16, 0.96-1.40), and of similar magnitude in term (1.22, 1.05-1.42) and preterm infants (1.18, 0.95-1.46).
The risk for a CCC appears to be higher in children born to women with schizophrenia. This finding introduces opportunities for targeted preconception counselling, optimization of maternal risk factors, and intervention to support a vulnerable parent population who will experience unique challenges caring for a child with CCCs.