ПЕРИНАТАЛЬНЫЕ И ПОСТНАТАЛЬНЫЕ ПРОБЛЕМЫ У БЕРЕМЕННЫХ: ЭПИДЕМИОЛОГИЯ, ЭТИОПАТОГЕНЕТИЧЕСКИЕ МЕХАНИЗМЫ ПСИХИЧЕСКИХ РАССТРОЙСТВ И ИХ ВЛИЯНИЕ НА СОСТОЯНИЕ ПЛОДА И БУДУЩЕГО РЕБЕНКА
Обзорная статья
Дата публикации: Июль 13, 2022
Ключевые слова
беременность
плод
перинатальный период
психические заболевания
плод
перинатальный период
психические заболевания
Как цитировать
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Аннотация
По данным современной научной литературы, психические заболевания в перинатальном периоде встречаются у 15-25% беременных и у 20-27% женщин в послеродовом периоде. Известно, что женщины с психическими расстройствами демонстрируют более высокую распространенность психосоциальных и соматических факторов риска, связанных с беременностью, а также состояний, сопутствующих беременности и усугубляемых ею, чем их здоровые сверстницы, однако исследования, посвященные их репродуктивному здоровью, все еще немногочисленны. Психические расстройства могут влиять на течение беременности из-за их влияния на эмоциональное состояние матери, ее функциональную активность и способность получать надлежащий дородовой уход, а после рождения ребенка нелеченное психическое заболевание матери может существенно повлиять на развитие и благополучие младенца. Все применяемые в настоящее время в психиатрии препараты проникают через плаценту. Их конкретные уровни в сыворотке плода неизвестны, но они могут обладать тератогенным действием. В обзоре литературы представлены данные исследований отдельных особенностей этиопатогенетических механизмов, лежащих в основе психических заболеваний во время беременности и после родов. Рассматриваются исследования, касающиеся влияния психических, соматических и эндокринных расстройств матери на плод. В качестве основных объектов изучения рассматривались случаи шизофрении и депрессий – основных психопатологических состояний, в первую очередь подвергающиеся риску рецидивирования у матерей в перинатальном периоде и после родов, а также возможное значение отдельных гипотез их патогенеза.Литература
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2. Vesga-Lopez O. et al. Psychiatric disorders in pregnant and postpartum women in the United States //Archives of general psychiatry. – 2008. – V. 65. – №. 7. – P. 805-815. doi: 10.1001/archpsyc.65.7.805.
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6. Fisher J. et al. Prevalence and determinants of common perinatal mental disorders in women in low-and lower-middle-income countries: a systematic review //Bulletin of the World Health Organization. – 2012. – V. 90. – P. 139-149.
7. Kulkarni J. et al. Estrogen in severe mental illness: a potential new treatment approach //Archives of General Psychiatry. – 2008. – V. 65. – №. 8. – P. 955-960. doi: 10.1001/archpsyc.65.8.955.
8. Altshuler L. L. et al. Pharmacologic management of psychiatric illness during pregnancy: dilemmas and guidelines //The American journal of psychiatry. – 1996. doi: 10.1176/ajp.153.5.592
9. Wisner K. L. et al. Pharmacologic treatment of depression during pregnancy //Jama. – 1999. – V. 282. – №. 13. – P. 1264-1269. doi: 10.1001/jama.282.13.1264.
10. Manu P. et al. Weight gain and obesity in schizophrenia: epidemiology, pathobiology, and management //Acta Psychiatrica Scandinavica. – 2015. – V. 132. – №. 2. – P. 97-108. doi: 10.1111/acps.12445.
11. Judd F. et al. Adverse obstetric and neonatal outcomes in women with severe mental illness: to what extent can they be prevented? //Schizophrenia Research. – 2014. – V. 157. – №. 1-3. – P. 305-309.
12. Vigod S. N. et al. Maternal and newborn outcomes among women with schizophrenia: a retrospective population‐based cohort study //BJOG: An International Journal of Obstetrics & Gynaecology. – 2014. – V. 121. – №. 5. – P. 566-574. doi: 10.1111/1471-0528.12567.
13. Debnath M., Venkatasubramanian G., Berk M. Fetal programming of schizophrenia: select mechanisms //Neuroscience & Biobehavioral Reviews. – 2015. – V. 49. – P. 90-104. doi: 10.1016/j.neubiorev.2014.12.003.
14. Barker D. J. P. et al. Fetal undernutrition and disease in later life //Reviews of reproduction. – 1997. – V. 2. – P. 105-112.
15. Auyeung B., Lombardo M. V., Baron-Cohen S. Prenatal and postnatal hormone effects on the human brain and cognition //Pflügers Archiv-European Journal of Physiology. – 2013. – V. 465. – №. 5. – P. 557-571. doi: 10.1007/s00424-013-1268.
16. Stachowiak M.K., Kucinski A., Curl R. et al. Schizophrenia: a neurodevelopmental disorder – integrative genomic hypothesis and therapeutic implications from a transgenic mouse model // Schizophr. Res. 2013. 143. 367–376. doi: 10.1016/j.schres.2012.11.004.
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21. Pazos M. A. et al. Estrogen mediates innate and adaptive immune alterations to influenza infection in pregnant mice //PloS one. – 2012. – V. 7. – №. 7. – P. e40502. doi: 10.1371/journal.pone.0040502.
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27. Shelton R. C. et al. Altered expression of genes involved in inflammation and apoptosis in frontal cortex in major depression //Molecular psychiatry. – 2011. – V. 16. – №. 7. – P. 751-762.
28. Bacher I. et al. Monoamine oxidase A binding in the prefrontal and anterior cingulate cortices during acute withdrawal from heavy cigarette smoking //Archives of general psychiatry. – 2011. – V. 68. – №. 8. – P. 817-826.
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