The British Journal of Psychiatry (2008) 193: 311-315. doi: 10.1192/bjp.bp.107.045146
© 2008 The Royal College of Psychiatrists
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Schizophrenia and offspring's risk for adverse pregnancy outcomes and infant death

Emma Nilsson, PhD

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, and Centre for Epidemiology, National Board of Health and Welfare, Stockholm

Christina M. Hultman, PsyD

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, and Department of Neuroscience, Psychiatry, Ulleråker, Uppsala University, Uppsala

Sven Cnattingius, MD, PhD

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm

Petra Otterblad Olausson, PhD

Centre for Epidemiology, National Board of Health and Welfare, Stockholm

Camilla Björk, MSc

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm

Paul Lichtenstein, PhD

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

Correspondence: Emma Nilsson, Centre for Epidemiology, National Board of Health and Welfare, SE-106 30 Stockholm, Sweden. Email: Emma.Nilsson{at}Socialstyrelsen.se

Declaration of interest

None. Funding detailed in Acknowledgements.

Background

Women with schizophrenia are at increased risk for adverse pregnancy outcomes. It is not known whether offspring born to fathers with schizophrenia also have an increased risk.

Aims

To evaluate paternal and maternal influences on the association between schizophrenia and pregnancy outcomes.

Method

A record linkage including 2 million births was made using Swedish population-based registers. The risk for adverse pregnancy outcomes was evaluated through logistic regression.

Results

Offspring with a mother or father with schizophrenia faced a doubled risk of infant mortality, which could not be explained by maternal behaviour alone during pregnancy. Excess infant death risk was largely attributable to post-neonatal death. Maternal factors (e.g. smoking) explained most of the other risks of adverse pregnancy outcomes among both mothers and fathers with schizophrenia.

Conclusions

The risks to offspring whose fathers had schizophrenia suggest that, in addition to maternal risk behaviour, non-optimal social and/or parenting circumstances are of importance.


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