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Prenatal Primary Prevention of Mental Illness by Micronutrient Supplements in Pregnancy.
American Journal of Psychiatry ( IF 17.7 ) Pub Date : 2018-03-21 , DOI: 10.1176/appi.ajp.2018.17070836
Robert Freedman 1 , Sharon K Hunter 1 , M Camille Hoffman 1
Affiliation  

Genes, infection, malnutrition, and other factors affecting fetal brain development are a major component of risk for a child's emotional development and later mental illnesses, including schizophrenia, bipolar disorder, and autism. Prenatal interventions to ameliorate that risk have yet to be established for clinical use. A systematic review of prenatal nutrients and childhood emotional development and later mental illness was performed. Randomized trials of folic acid, phosphatidylcholine, and omega-3 fatty acid supplements assess effects of doses beyond those adequate to remedy deficiencies to promote normal fetal development despite genetic and environmental risks. Folic acid to prevent neural tube defects is an example. Vitamins A and D are currently recommended at maximum levels, but women's incomplete compliance permits observational studies of their effects. Folic acid and phosphatidylcholine supplements have shown evidence for improving childhood emotional development associated with later mental illnesses. Vitamins A and D decreased the risk for schizophrenia and autism in retrospective observations. Omega-3 fatty acid supplementation during early pregnancy increased the risk for schizophrenia and increased symptoms of attention deficit hyperactivity disorder, but in later pregnancy it decreased childhood wheezing and premature birth. Studies are complicated by the length of time between birth and the emergence of mental illnesses like schizophrenia, compared with anomalies like facial clefts identified at birth. As part of comprehensive maternal and fetal care, prenatal nutrient interventions should be further considered as uniquely effective first steps in decreasing risk for future psychiatric and other illnesses in newborn children. [AJP at 175: Remembering Our Past As We Envision Our Future July 1959: Longitudinal Observations of Biological Deviations in a Schizophrenic Infant Barbara Fish described the course of an infant born with fluctuating motor problems who developed schizophrenia. (Am J Psychiatry 1959; 116:25-31 )].

中文翻译:

孕期补充微量营养素对产​​前精神疾病的初级预防。

基因,感染,营养不良和其他影响胎儿大脑发育的因素是儿童情绪发育和后来的精神疾病(包括精神分裂症,躁郁症和自闭症)的主要危险因素。改善这种风险的产前干预措施尚未建立用于临床。对产前营养和儿童情绪发展以及后来的精神疾病进行了系统评价。叶酸,磷脂酰胆碱和omega-3脂肪酸补充剂的随机试验评估了尽管有遗传和环境风险,但仍足以弥补不足以促进胎儿正常发育的剂量所产生的影响。叶酸可预防神经管缺陷。目前建议维生素A和D的最高含量,但女性 不完全的依从性允许对其效果进行观察性研究。叶酸和磷脂酰胆碱补充剂已显示出改善与晚期精神疾病相关的儿童情感发展的证据。回顾性观察显示,维生素A和D降低了精神分裂症和自闭症的风险。妊娠早期补充Omega-3脂肪酸会增加精神分裂症的风险,并增加注意力不足过动症的症状,但在妊娠后期,它会减少儿童的喘息和早产。与出生时发现的面部裂痕等异常现象相比,出生至出现精神分裂症等精神疾病的时间间隔使研究变得复杂。作为全面母婴保健的一部分,产前营养干预措施应进一步被认为是降低新生婴儿未来患精神病和其他疾病风险的独特有效的第一步。[AJP 175:在我们展望未来时记住我们的过去:1959年7月:精神分裂症婴儿芭芭拉·巴巴什(Barbara Fish)的生物学偏差的纵向观察描述了出生时患有运动障碍的精神分裂症婴儿的病程。(Am J Psychiatry 1959; 116:25-31)]。
更新日期:2018-03-21
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