Impact of Obstetric Complications in Subjects at Clinical High Risk for Psychosis: A Systematic Review and Meta-Analysis

IF 5 2区医学 Q1 PSYCHIATRY

Acta Psychiatrica Scandinavica Pub Date : 2025-05-04 DOI:10.1111/acps.13816

Inmaculada Baeza, Jordina Tor, Elena de la Serna, Gisela Sugranyes, Fàtima Crispi, Montserrat Izquierdo-Renau, Marta del Olmo, Montserrat Dolz, Clemente García-Rizo

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引用次数: 0

Abstract

Introduction

Exposure to obstetric complications (OCs) increases the risk of developing psychosis and schizophrenia in offspring. However, studies with subjects at clinical high risk for psychosis (CHR) have reported inconsistent results. We conducted a systematic review and meta-analysis to evaluate the prevalence of OCs among CHR subjects and controls and examine their impact on the transition to psychosis.

Methods

Four databases (Web of Science, PubMed, Latindex, and Dialnet) were systematically searched for articles published between 1995 and June 6, 2024. The risk of bias was assessed using the Newcastle–Ottawa scale. Articles providing data on OCs in CHR subjects were included.

Results

A total of 6037 records were retrieved through systematic and citation searches. Nine articles met the inclusion criteria for our systematic review and provided data for meta-analysis. A total of 555 CHR participants were included. Meta-analysis showed a significantly higher prevalence of OCs in CHR subjects versus controls: RR = 1.45 (95% CI: 1.16, 1.81), (Z = 3.27, p = 0.0011). Data from three longitudinal studies assessed transition to psychosis and our meta-analysis found a trend toward an increased risk of transition in CHR subjects with a history of OCs compared to others: RR = 2.05 (95% CI: 0.98, 4.26), Z = 1.91, p = 0.056.

Conclusions

CHR for psychosis was associated with OCs, though their role in the transition to psychosis requires further study. OCs should be recorded and analyzed in CHR individuals, considering their potential clinical implications.

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产科并发症对临床精神病高危患者的影响：一项系统回顾和荟萃分析

暴露于产科并发症（OCs）会增加后代患精神病和精神分裂症的风险。然而，对临床精神病高危人群（CHR）的研究报告了不一致的结果。我们进行了一项系统回顾和荟萃分析，以评估CHR受试者和对照组中OCs的患病率，并检查其对向精神病过渡的影响。方法系统检索Web of Science、PubMed、Latindex和Dialnet 4个数据库1995年至2024年6月6日期间发表的论文。偏倚风险采用纽卡斯尔-渥太华量表进行评估。纳入了提供CHR受试者OCs数据的文章。结果通过系统检索和引文检索，共检索到文献6037篇。9篇文章符合我们系统评价的纳入标准，并为meta分析提供了数据。共纳入555名CHR参与者。荟萃分析显示，CHR组的OCs患病率明显高于对照组：RR = 1.45 (95% CI: 1.16, 1.81), （Z = 3.27, p = 0.0011）。三项纵向研究的数据评估了向精神病的转变，我们的荟萃分析发现，与其他人相比，有OCs病史的CHR受试者的转变风险有增加的趋势：RR = 2.05 (95% CI: 0.98, 4.26), Z = 1.91, p = 0.056。结论精神病的CHR与OCs相关，但OCs在向精神病过渡中的作用有待进一步研究。考虑到其潜在的临床意义，应记录和分析CHR患者的OCs。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Psychiatrica Scandinavica 医学-精神病学

CiteScore

11.20

自引率

3.00%

发文量

135

审稿时长

6-12 weeks

期刊介绍： Acta Psychiatrica Scandinavica acts as an international forum for the dissemination of information advancing the science and practice of psychiatry. In particular we focus on communicating frontline research to clinical psychiatrists and psychiatric researchers. Acta Psychiatrica Scandinavica has traditionally been and remains a journal focusing predominantly on clinical psychiatry, but translational psychiatry is a topic of growing importance to our readers. Therefore, the journal welcomes submission of manuscripts based on both clinical- and more translational (e.g. preclinical and epidemiological) research. When preparing manuscripts based on translational studies for submission to Acta Psychiatrica Scandinavica, the authors should place emphasis on the clinical significance of the research question and the findings. Manuscripts based solely on preclinical research (e.g. animal models) are normally not considered for publication in the Journal.