Hostname: page-component-7c8c6479df-nwzlb Total loading time: 0 Render date: 2024-03-29T07:16:18.967Z Has data issue: false hasContentIssue false

Prenatal and neonatal risk factors for schizophrenia

Published online by Cambridge University Press:  03 January 2018

Christina M. Hultman*
Affiliation:
Department of Clinical Psychology, University of Uppsala, Sweden
Arne Öhman
Affiliation:
Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
Sven Cnattingius
Affiliation:
Department of Cancer Epidemiology, University of Uppsala, Sweden
Ing-Marie Wieselgren
Affiliation:
Department of Psychiatry, University of Uppsala, Sweden
Leif H. Lindström
Affiliation:
Department of Psychiatric Research, Västerås Central Hospital, University of Uppsala, Sweden
*
Dr C. M. Hultman, Department of Psychiatry, Ulleråker, University of Uppsala, 750 17 Uppsala, Sweden. Fax:(+46) 18-154157

Abstract

Background

The present study examines the effects of independent, single pre- and perinatal risk factors and rates of obstetric complications upon the subsequent development of schizophrenia.

Method

This study was based on prospectively recorded birth records of 107 cases (82 with schizophrenic disorders and 25 with other psychotic reactions) and 214 controls, individually matched by gender and time and place of birth. Variables univariately associated with significantly elevated risk were entered in a logistic regression model.

Results

A high non-optimality summary score (> or = 7 complications of 34 possible) was a significant risk estimate for the total index group (OR 4.58, 95% CI 1.74–12.03) and the 82 schizophrenic patients (OR 3.67, CI 1.30–10.36). Patients with 2–6 complications also had an increased, although lower, risk (OR 1.67, CI 1.02–2.75). A disproportionate birth weight for body length (OR 3.57, CI 1.77–7.19) and a small head circumference (OR 3.93, CI 1.32–11.71) were the strongest independent risk factors.

Conclusions

A contribution of obstetric complications to the risk of schizophrenia was confirmed. Only aberrations in physical size remained as individual independent risk factors.

Type
Papers
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM-III). Washington. DC; APA.Google Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn. revised) (DSM-III-R). Washington, DC: APA.Google Scholar
Cantor-Graae, E., McNeil, T. F., Sjösrtröm, IC., et al (1994) Obstetric connplications and their relationship to other etiological risk factors in schizophrenia. A case-control study. Journal of Nervous and Mental Disease, 182, 645650.Google Scholar
Cnattingius, S., Forman, M. R., Berendas, H. W., et al (1992) Delayed childbearing and risk of adverse perinatal outcome. A population-based study. Journal of the American Medical Association, 268, 886890.Google Scholar
Geddes, J. R., & Lawrie, S. M. (1995) Obstetric complications and schizophrenia: A meta-analysis. British Journal of Psychiatry, 167, 786793.Google Scholar
Gerhard, I., Voilmar, B., Runnabaum, B., et al (1987) Weight percentile at birth. II: Prediction by endocrinological and sonographic measurements. European Journal of Obstetrics & Gynecology and Reproduaive Biology, 26, 313328.CrossRefGoogle ScholarPubMed
Gillberg, C., Wahlström, J., Forsman, A., et al (1986) Teenage psychoses – epidemiology classification and reduced optimality in the pre-. peri- and neonatal periods. Journol of Child Psychology and Psychiatry, 27, 8798.Google Scholar
Guy, J. D., Majorski, L. V., Wallace, C. J., et al (1983) The incidence of minor physical anomalies in adult male schizophrenics. Schizophrenia Bulletin, 9, 571582.Google Scholar
Karlberg, P., Priolisi, A., Landström, T., et al (1977) Clinical analyses and causes of death with emphasis on perinatal mortality In Fundamentals of Mortality Risks During the Perinatal Period and Infancy, vol.9 (ed. Falkner, F.), pp. 86120. Basel: Karger.Google Scholar
Kinnell, H. G. (1983) Parental age in schizophrenia (letter). British Journal of Psychiatry 142, 204.Google Scholar
Kunugi, H., Takei, N., Murray, R. M., et al (1996) Small head circumference at birth in schizophrenia. Schizophrenia Research, 20, 165170.Google Scholar
Kyllerman, M. & Hagberg, G. (1983) Reduced optimality in pre- and perinatal conditions in a Swedish newborn population. Neuropediatrics, 14, 3742.Google Scholar
Lubchenco, L. O. (1976) The High-Risk Infant: Major Problems in Clinical Pediatrics, Philadelphia. PA: Saunders.Google Scholar
McNeil, T. F. (1995) Perinatal risk factors and schizophrenia: Selective review and methodological concerns. Epidemiologic Reviews, 17, 107112.Google Scholar
McNeil, T. F., Cantor-Graae, E., Nordström, L. G., et al (1993) Head circumference in “preschizophrenic” and control neonates. British Journal of Psychiatry, 162, 517523.Google Scholar
McNeil, T. F., Cantor-Graae, E., Nordström, L. G., et al & Sjöström, K. (1994) Obstetric complications as antecedents of schizophrenia: Empirical effects of using different obstetric complication scales. Journal of Psychiatric Research, 28, 519530.Google Scholar
Michaeiis, R., Haug, S., Majewski, F., et al (1980). Obstetrische und postnatale Komplikationen bei Kindern mit einer Alkoholembryopathie. Monatsschrift Kinderheilkunde, 128, 2126.Google Scholar
Prechtl, H. F. F. (1968) Neurological findings in newborn infants after pre- and paranatal complications. In Aspects of Prematurity Nutrica Symposia 1967 (eds Jonxis, J. H. R. Visser, H. K. A., Troelstra, J. A. et al), pp. 303321. Leiden, Holland: H. E. Stenfert Kroese N. V. Google Scholar
Raumussen, P. (1982) Neuropediatric aspects of seven-year-old children with perceptual, motor and attention deficits. Dept of Pediatrics II and Clinical Neurophysiology PhD thesis. University of Gothenburg. Sweden.Google Scholar
SAS Institute Inc. (1988) SAS/STAT Guide for Personal Computers. Version 6 Edition, Cary NC: SAS Institute Inc.Google Scholar
Sonnander, K. & Gustavson, K.-H. (1987) Reduced optimality as an indicator of developmental status at 18 months and school achievements at 8 years. Neuropediatrics, 18, 131137.Google Scholar
Stave, U. & Ruvalo, C. (1980) Neurological devetopment in very low birth weight infants. Early Human Devehpment, 4, 229241.Google Scholar
Touwen, B. C. L., Hubfas, H. J., Jurgans-van dar Zaa, A. D. et al (1980) Obstetrical condition and neonatal neurological morbidity An analysis with the help of the optimality concept. Early Human Development, 4/3, 207228.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.