[autismo-biologia] lutto come fattore di rischio
Dr Stefano Palazzi
s.palazzi a ausl.fe.it
Sab 11 Lug 2009 16:11:38 CEST
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.
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