Early life exposure to infectious diseases confers risk for adult psychiatric disorders but relatively few human population studies have examined associations with childhood mental disorder. Here we examined the effects of exposure to maternal infection during pregnancy, and child infectious diseases in early childhood (birth to age 4 years), in relation to first mental disorder diagnosis (age 5-13 years). The study sample comprised 71,841 children represented in a population cohort of children in New South Wales, Australia, followed from birth to early adolescence via linkage of administrative registers. Childhood exposure to infectious disease was determined during the prenatal period (i.e., maternal infection during gestation), and in early childhood (between birth and age 4 years) using the NSW Ministry of Health Admitted Patients data collection. Days to first diagnosis with a mental disorder was determined from recorded diagnoses between age 5-13 years in the NSW Ministry of Health’s Admitted Patients, Emergency Department and Mental Health Ambulatory data collections. While crude hazard ratios for both prenatal infection and childhood infection exposures indicated significantly earlier diagnosis with mental disorders associated with both of these risk factors, only childhood infection exposure was associated with higher adjusted hazard ratios (HRa) for any diagnoses (HRa=1.21, 95% CI=1.11-1.32), externalising disorders (HRa=1.45, 95% CI 1.18-1.79) and developmental disorders (HR=1.82, 95% CI 1.49-2.22) when the effects of maternal and early childhood (age <5 years) mental disorders were taken into account. Exposure to infectious diseases during early childhood, but not prenatal infection exposure, appears to be associated with earlier diagnosis of mental disorders in childhood.

早年接触传染病会增加患成人精神障碍的风险，但相对较少的人群研究调查了与儿童精神障碍的关联。在这里，我们研究了怀孕期间暴露于母体感染和儿童早期（出生至 4 岁）的儿童传染病对首次精神障碍诊断（5-13 岁）的影响。研究样本包括澳大利亚新南威尔士州儿童人口队列中的 71,841 名儿童，通过行政登记的联系从出生到青春期早期。在产前期间确定儿童接触传染病（即妊娠期间的母体感染），使用新南威尔士州卫生部收治患者数据收集的儿童早期（出生至 4 岁之间）。首次诊断出精神障碍的天数是根据新南威尔士州卫生部的入院患者、急诊科和心理健康门诊数据收集中记录的 5-13 岁诊断结果确定的。虽然产前感染和儿童感染暴露的粗略风险比表明与这两个风险因素相关的精神障碍的诊断显着更早，但只有儿童感染暴露与任何诊断的更高调整风险比 (HRa) 相关 (HRa=1.21, 95 % CI=1.11-1.32)、外化障碍 (HRa=1.45, 95% CI 1.18-1.79) 和发育障碍 (HR=1.82, 95% CI 1.49-2.22) 当母亲和幼儿期（年龄 < 5 年）精神障碍被考虑在内。儿童早期接触传染病，但与产前感染接触无关，似乎与儿童早期精神障碍的诊断有关。