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Obstetric complications link to schizophrenia risk confirmed
By Liam Davenport
26 November 2007
Schizophr Res 2007; 97: 51-59

Maternal obstetric factors such as prematurity, hypoxia, maternal infections, and maternal behaviors are modestly associated with an increased risk for later schizophrenia among offspring, after taking into account confounding factors, say Danish and US investigators.

Previous studies have linked pregnancy complications, abnormal fetal growth and development, and delivery complications to an increased risk for schizophrenia, but few have taken into account a broad range of potential confounding factors.

Majella Byrne, from Aarhus University in Denmark, and colleagues conducted a national population nested case-control study involving 1039 first admissions to, or contacts with, Danish psychiatric services with a schizophrenia diagnosis and 24,826 individually matched controls for whom maternal identity was known.

The participants were born between 1973 and 1983 and 65% of both patients and controls were males. The team examined data from the Danish Psychiatric Central Register, the Integrated Database for Longitudinal Labour Market Research, the Danish Medical Birth Register, and the Danish National Hospital Register to determine associations with schizophrenia risk.

Multivariate analysis taking into account family psychiatric history, socioeconomic and other demographic factors, and other obstetric factors revealed that maternal non-attendance at antenatal appointments, gestational age of 37 weeks or below, maternal influenza, pre-eclampsia, manual extraction of the baby, and maternal sepsis of childbirth and the puerperium were associated with the risk for schizophrenia, at incidence rate ratios of 2.08, 1.51, 8.2, 2.72, 2.39, 2.43, and 2.91, respectively.

The researchers also note in the journal Schizophrenia Research that there were no significant interactions found between any of the obstetric complications and either gender or family history of psychiatric disorders.

They conclude: ?The finding that obstetric complications predict heightened risk for schizophrenia, even in the presence of the potential confounders we included, and even in the subsample with no family history of schizophrenia, constitutes evidence that obstetric complications may be causes of schizophrenia.?

The team adds: ?Our data support previous reports that the mechanism for increased risk for schizophrenia after exposure to obstetric complications might be fetal hypoxia, prematurity, and other prenatal complications.?

Abstract
 

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