[autismo-biologia] lutto come fattore di rischio

[Dr Stefano Palazzi]

L'impressione di contradditorietà in alcuni studi sullo stress può 
dipendere dall'imprecisione terminologica.  E' interessante che un altro 
lavoro proveniente dal medesimo centro suggerisca che nei pretermine e 
sottopeso lo stress del lutto aumenti la suscettibilità alla paralisi 
cerebrale infantile  (v. sotto), mentre ciò non avverrebbe nell'autismo 
(articolo precedente). Sia in epidemiologia, sia in genetica, le 
manifestazioni cortisol-related potrebbero risultare diverse se si 
misura il lutto come stressor (life event) oppure come percezione di 
disagio (being stressed).

Li J, Vestergaard M, Obel C, Precht DH, Christensen J, Lu M, Olsen J.  
*Prenatal Stress and Cerebral Palsy: A Nationwide Cohort Study in 
Denmark.* Psychosom Med. 2009 May 29. [Epub ahead of print]

*Objectives*: Exposure to prenatal stress may affect neurodevelopment of 
the fetus, but whether this exposure increases the risk of cerebral 
palsy (CP) later in life is unknown. We aimed to examine the association 
between maternal bereavement during the prenatal time period and CP in 
childhood.
*Methods*: We conducted a nationwide cohort study by linking information 
from nationwide registers. All 1,501,894 singletons born in Denmark from 
1979 to 2004 were followed up from birth to the end of 2006. We 
identified 39,601 children whose mothers lost a close relative (child, 
spouse, parent, sibling) during pregnancy or up to 1 year before 
pregnancy and they were classified as the exposed group. The outcome of 
interest was the diagnosis of CP as registered in the National Hospital 
Register. We used Cox Regression to estimate the hazard ratios (HRs).
*Results*: Exposure to maternal bereavement after the loss of a child 
during the prenatal period was associated with an increased risk of CP 
among children born preterm without intrauterine growth retardation (HR 
2.26, 95% CI, 1.09-3.79) and among children born at term with 
intrauterine growth retardation (HR 2.01, 95% CI, 1.04-3.89). Prenatal 
stress after maternal bereavement by loss of other relatives was not 
associated with an increased risk of CP.
*Conclusions*: Our data suggest that extremely severe stress in prenatal 
life could increase the susceptibility for CP among children born 
preterm or with impaired fetal growth.

Saluti cordiali - SPal.