母亲分娩前后吸烟与后代精神疾病关系的孟德尔随机化研究  

A Mendelian randomization study of relationship between maternal smoking around birth and offspring psychiatric disorders

作　　者：张蓓 张郑 任浩 王兴莲 邱海棠[1] 李泽辉 李延卫 蒋成刚 罗庆华[1] ZHANG Bei;ZHANG Zheng;REN Hao;WANG Xinglian;QIU Haitang;LI Zehui;LI Yanwei;JIANG Chenggang;LUO Qinghua(Department of Psychiatry,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China;Department of Mental Rehabilitation Medicine,Mental Health Centre of Yuzhong District,Chongqing 400014,China;Department of Sleep and Psychology,Chongqing Health Center for Women and Children,Chongqing 401147,China;Chongqing Changshou District,Mental Health Center,Chongqing 401231,China;Department of Nephrology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China;Department of Cardiology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院精神科,重庆400016 [2]重庆市渝中区精神卫生中心精神康复医学科,重庆400014 [3]重庆市妇幼保健院睡眠心理科,重庆401147 [4]重庆市长寿区精神卫生中心,重庆401231 [5]重庆医科大学附属第一医院肾脏内科,重庆400016 [6]重庆医科大学附属第一医院心血管内科,重庆400016

出　　处：《中国心理卫生杂志》2025年第3期207-214,共8页Chinese Mental Health Journal

基　　金：精神障碍智能医疗辅助系统的开发(KJZD-K202400410)。

摘　　要：目的:探讨母亲分娩前后吸烟(MSAB)对后代注意力缺陷多动障碍(ADHD)、孤独症谱系障碍(ASD)、双相情感障碍(BD)和重度抑郁症(MDD)的因果关系。方法:从基因组范围关联研究(GWAS)中提取MSAB和4种精神疾病的GWAS数据集。采用孟德尔随机化(MR)方法,以逆方差加权(IVW)作为主要分析方法,并结合加权中位数(WM)、MR-Egger回归和MR-PRESSO进行敏感性分析和异常值校正,MR分析结果使用优势比(OR)表示,并进行错误发现率(FDR)校正。结果:MR分析显示,MSAB与ADHD(OR=5.36,95%CI=2.58~7.63,P FDR=0.003)、MDD(OR=1.92,95%CI=1.29~2.88,P FDR=0.003)、BD(OR=6.33,95%CI=1.56~8.73,P FDR=0.013)风险增加之间存在因果关系,但与ASD(OR=1.66,95%CI=0.23~5.87,P FDR=0.616)的关联无统计学意义。结论:本研究提示,母亲分娩前后吸烟与后代注意力缺陷多动障碍、双相情感障碍和重性抑郁症风险增高之间有潜在因果联系。Objective:To investigate the causal impact of maternal smoking around birth(MSAB)on offspring′s risk of attention deficit hyperactivity disorder(ADHD),autism spectrum disorder(ASD),bipolar disorder(BD),and major depressive disorder(MDD).Methods:The datasets for MSAB and 4 psychiatric disorders were extracted from genome-wide association studies(GWAS).Mendelian randomization(MR)was employed,using inverse variance weighting(IVW)as the primary analysis method.Sensitivity analyses and outlier correction were conducted using weighted median(WM),MR-Egger regression,and MR-PRESSO.The results were expressed as odds ratios(OR)and corrected for false discovery rate(FDR).Results:MR analysis showed significant causal relationships between MSAB and increased risk of ADHD(OR=5.36,95%CI=2.58-7.63,P FDR=0.003),MDD(OR=1.92,95%CI=1.29-2.88,P FDR=0.003),and BD(OR=6.33,95%CI=1.56-8.73,P FDR=0.013).However,no statistically significant association was found between MSAB and ASD(OR=1.66,95%CI=0.23-5.87,P FDR=0.616).Conclusion:This study suggests a potential causal link between maternal smoking around the time of birth and an increased risk of attention deficit hyperactivity disorder,bipolar disorder,and major depressive disorder in offspring.

关 键 词：吸烟 注意缺陷与多动障碍 双相情感障碍 抑郁症 孟德尔随机化 

分 类 号：R749.02[医药卫生—神经病学与精神病学] R749.94[医药卫生—临床医学]