孕期经历地震对不同性别子代精神分裂症发病影响

Effects of earthquake during pregnancy on the incidence of schizophrenia in offspring of different genders

目的探究母孕期地震应激暴露对子代精神分裂症发病的影响,以及对不同性别子代发病影响差异。方法从《唐山市统计年鉴》以及1982年全国人口普查河北省的数据获得1972年8月至1981年5月出生于唐山市的人口(子代)队列总人数,根据母孕期是否经历地震分为暴露组和对照组。从唐山市9家精神病专科医院病历资料中获取队列患精神分裂症的情况。结果调整死亡人口后,暴露组为71262人,对照组为760310人。暴露组精神分裂症663例(调整发病率9.4‰),对照组5761例(调整发病率7.6‰),调整后相对危险度(relative risk,RR)为1.23(95%CI:1.14~1.33)。暴露组男性中精神分裂症322例(发病率8.8‰),对照组男性中精神分裂症2662例(发病率7.8‰),RR为1.13(95%CI:1.01~1.27)。暴露组女性中精神分裂症341例(发病率0.99%),对照组女性中精神分裂症3099例(发病率0.98%),组间差异无统计学意义(P=0.36)。在两组男性中,母孕早(RR=1.46,95%CI:1.10~1.93)、中(RR=1.65,95%CI:1.26~2.11)期暴露于地震者与同月份(不同年)出生的对照相比,精神分裂症发病率差异有统计学意义(均P<0.05)。在两组女性中,母孕中(RR=1.37,95%CI:1.02~1.85)、晚(RR=1.80,95%CI:1.42~2.29)期暴露地震者与同月份(不同年)出生的对照相比,发病率差异有统计学意义(均P<0.05)。结论母孕期经历地震会使子代精神分裂症发病风险增加,且对男性子代更为明显。母孕早、中期经历地震使男性子代发病风险增加,母孕中、晚期经历地震使女性子代发病风险增加。

Objective To explore the effects of earthquake stress exposure during pregnancy on the incidence of schizophrenia and on the incidence of offspring of different genders.Methods This was a retrospective cohort study.The data of people in the cohort was obtained from the statistical yearbook of Tangshan City published by the government and from the 1982 national census of Hebei Province.According to whether the mother experienced an earthquake during pregnancy,people were divided into exposure group and control group.The incidence of schizophrenia in the cohort was obtained from the medical records of 9 psychiatric hospitals in Tangshan city.Result After adjusting for the death population,there were 71262 in the exposure group and 760310 in the control group.There were 663 cases of schizophrenia in the exposure group and 5761 cases in the control group.The adjusted incidence rate was higher in the exposure group than in the control group(9.4‰vs.7.6‰)and the adjusted relative risk(RR)was 1.23(95%CI:1.14~1.33).There were 322 cases of schizophrenia in the male offspring exposure group and 2662 cases in the control group,with an incidence of 8.8‰and 7.8‰(RR=1.13,95%CI:1.01~1.27),respectively.There were 341 cases of female schizophrenia in the exposure group,with an incidence of 0.99%,while in the control group,there were 3099 cases,with an incidence of 0.98%.The difference was not significant(P>0.05).In the male offspring,the differences were significant in the incidence between the early(RR=1.46,95%CI:1.10~1.93)and second(RR=1.65,95%CI:1.26~2.11)trimester exposure group and the control group(P<0.05).There was no significant difference between the two groups in the third trimester of pregnancy(P>0.05).Among the female offspring,the differences were significant in the incidence between the exposure group in the second(RR=1.37,95%CI:1.02~1.85)and third(RR=1.80,95%CI:11.42~2.29)trimester of pregnancy and the control group(P<0.05).There was no significant difference in incidence between the two groups in the early trimester(P>0.05).Conclusion Maternal experience of earthquake stress during pregnancy will increase the risk of schizophrenia in offspring,particularly male offspring.Earthquake stress in the early and second trimester of pregnancy increases the risk in male offspring,while earthquake stress in the middle and late pregnancy increases the risk in female offspring.