JAMA Psychiatry：妊娠期流感或为后代双相情感障碍危险因素

　　美国一项研究表明，妊娠期流感可能为后代双相情感障碍的危险因素之一，预防妊娠期流感可能降低后代双相情感障碍风险。论文于5月8日在线发表于《JAMA精神病学》（JAMA Psychiatry）。

　　此项研究共纳入92例经确认的双相情感障碍患者，以及722例出生日期、性别和居住与之相匹配的对照者。利用相关资料确认孕母在妊娠期间的流感罹患情况，并评估妊娠期流感与后代双相情感障碍的相关性。

　　结果显示，在妊娠期间的任何时间，孕母流感暴露后双相情感障碍的风险均显著升高近4倍（比值比[OR] 3.82）。孕母年龄、种族、教育程度、分娩时胎龄和孕母精神疾病均未对上述结果造成混淆。

与情感障碍相关的拓展阅读：

• BJPsych：氟西汀、碳酸锂治疗循环型双相情感障碍的复发率相似
• BMC MED：磺脲类和二甲双胍联用或降2型糖尿病患者情感障碍风险 更多信息请点击：有关情感障碍更多资讯

Gestational Influenza and Bipolar Disorder in Adult Offspring
Importance 
Gestational influenza has been associated previously with schizophrenia in offspring, but the relationship between this exposure and bipolar disorder (BD) is unclear. The identification of gestational influenza as a risk factor for BD may have potential for preventive approaches.
Objective 
To test the hypothesis that maternal influenza during pregnancy is related to BD among offspring.
Design 
Nested case-control study of a population-based birth cohort from the Child Health and Development Study (CHDS). From January 1, 1959, through December 31, 1966, the CHDS recruited nearly all pregnant women receiving obstetric care from the Kaiser Permanente Medical Care Plan, Northern California Region (KPNC). Data on treated maternal influenza from the CHDS were used. Potential cases with BD from the cohort were identified by database linkages of identifiers among the CHDS, Kaiser Permanente database, and a large county health care database; by a mailed questionnaire to the CHDS cohort with subsequent interviews; and from an earlier psychiatric follow-up study on this birth cohort.
Setting 
The CHDS, Kaiser Permanente, and county health care databases.
Participants 
Cases of BD (n = 92) confirmed by structured research interviews and consensus diagnosis among the 214 subjects (48% of those ascertained) who participated and control subjects (n = 722) matched on date of birth, sex, and membership in KPNC or residence in Alameda County.
Exposures 
Influenza.
Main Outcome and Measures 
Bipolar I or II disorder, BD not otherwise specified, or BD with psychotic features.
Results 
We found a significant, nearly 4-fold increase in the risk of BD (odds ratio, 3.82 [95% CI, 1.58-9.24; P = .003]) after exposure to maternal influenza at any time during pregnancy. The findings were not confounded by maternal age, race, educational level, gestational age at birth, and maternal psychiatric disorders.
Conclusions and Relevance 
Maternal influenza may be a risk factor for BD. Although replication is required, the findings suggest that prevention of maternal influenza during pregnancy may reduce the risk of BD.