Prenatal and perinatal risk factors for bipolar disorder: A systematic review and meta-analysis

Shintani, Augusto Ossamu; Rabelo‐da‐Ponte, Francisco Diego; Marchionatti, Lauro Estivalete; Watts, Devon; Souza, Fernando Ferreira de; Machado, Cristiane dos Santos; Pulice, Rafaela Fernandes; Signori, Giovanna Maiolli; Luzini, Rafael Rocha; Kauer-Sant’Anna, Márcia; Passos, Ives Cavalcante

doi:10.1016/j.neubiorev.2022.104960

Cited by 9 publications

(3 citation statements)

References 37 publications

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“…Although all of the associations identified in our study were weak, the present investigation demonstrates that there is an association between some perinatal factors, subclinical hypomania, and 'high-risk' for BD. These associations provide further support for the Developmental Risk Factor Model's tenability in the context of BD (Kloiber et al, 2020;Shintani et al, 2023), which is particularly promising given this model operationalises subclinical symptoms and psychiatric disorders within a phenotypic continuum (Murray et al, 2017).…”

Section: Research and Clinical Implicationsmentioning

confidence: 64%

“…Nonetheless, perinatal risk factors correlated with later mental illness, such as prenatal alcohol exposure (Easey et al, 2019;Lees et al, 2020), have yet to be clarified in relation to the BD and subclinical hypomania phenotypes. A recent meta-analysis of 27 studies exploring the association between exposure to 18 perinatal events and BD identified peripartum asphyxia, maternal stress during pregnancy, low birth weight (below 2500g), and obstetric complications (e.g., delivery by planned caesarean section) as significant early correlates of the disorder (Shintani et al, 2023). The influence of other perinatal factors remains unclear due to small sample sizes, a sparsity of longitudinal evidence, and conflicting findings.…”

Section: Introductionmentioning

confidence: 99%

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Perinatal risk factors and subclinical hypomania: a prospective community study

González-Calvo,

Ronald,

Shakoor

et al. 2024

Preprint

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BackgroundPerinatal risk factors are implicated in the development of psychopathology, but their role in bipolar disorder (BD) and hypomania is unclear. Using data from a prospective community cohort, this is the first study to investigate the association between a range of perinatal risk factors, hypomanic symptoms, and ‘high-risk’ for BD in the general population. MethodsParent report of perinatal events were available for 26,040 eighteen-month-olds from the Twins Early Development Study. Subsequent self-report hypomania was measured at ages 16 (Hypomania Checklist-16; N=2,943) and 26 (Mood Disorders Questionnaire; N=7,748). Participants were categorised as ‘high-risk’ for BD using established classifications. Linear and logistic regressions were conducted within a generalised estimating equations framework to account for relatedness in the sample. Results Prenatal alcohol exposure (β=0.08, SE=0.04, p=.0002) and number of alcohol units consumed (β=0.09, SE=0.02, p<.0001) were associated with hypomanic symptoms at age 16, and number of alcohol units (OR=1.13, 95% CI:1.06–1.21, p=.0003) and maternal stress (OR=1.68, 95% CI:1.21–2.34, p=.002) were associated with ‘high-risk’ for BD age 16. Prenatal tobacco exposure (β=0.10, SE=0.04, p<.0001) and number of cigarettes smoked (β=0.10, SE=0.01, p<.0001) were associated with hypomanic symptoms and ‘high-risk’ for BD at age 26, although these result were attenuated controlling for parental psychiatric history.LimitationsFamilial confounding could not be fully adjusted for. Rater reports include some biases.ConclusionsThese findings show perinatal risk factors to be associated with subclinical hypomania and ‘high-risk’ for BD. Future work should explore the mechanisms underlying these longitudinal associations, which could shed light on prevention and intervention efforts.

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Section: Research and Clinical Implicationsmentioning

confidence: 64%

Section: Introductionmentioning

confidence: 99%

Perinatal risk factors and subclinical hypomania: a prospective community study

González-Calvo,

Ronald,

Shakoor

et al. 2024

Preprint

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“…This aligns with findings from a recent umbrella review, which demonstrated that a history of childhood trauma is linked with various mental disorders [ 7 ]. Likewise, urbanicity, advanced paternal age, and obstetric complications have been identified to show transdiagnostic associations [ 8 , 9 , 10 , 11 , 12 ]. Environmental exposures are intricately entwined, showcasing both causative and non-causative associations, along with complex interactions.…”

Section: Introductionmentioning

confidence: 99%

The Associations of Exposome Score with Various Domains of Psychopathology: A Network Analysis in a Non-Clinical Sample

Rejek,

Misiak

2024

Brain Sciences

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Background: The intricate correlation between environmental exposures and mental health outcomes is increasingly acknowledged in psychiatric research. This study investigated the relationship between cumulative environmental risk factors, as represented by the exposome score (ES), and various domains of psychopathology within a non-clinical sample using a network analysis. Methods: We recruited 1100 participants (aged 18–35 years, 51.4% females) via a computer-assisted web interview, assessing psychopathological symptoms using standardized questionnaires. Environmental exposures, including season of birth, obstetric complications, advanced paternal age, childhood trauma, cannabis use, and urban upbringing, were self-reported to calculate the ES. Results: A network analysis revealed significant associations of the ES with psychotic-like experiences (PLEs) (weight = 0.113), manic (weight = 0.072), and attention-deficit/hyperactivity disorder symptoms (weight = 0.062). These connections did not differ significantly with respect to their weights. Depressive symptoms had the highest centrality and predictability. The mean predictability across all nodes included in the network was 0.344. Conclusions: These findings underscore the transdiagnostic nature of environmental exposures, aligning with previous research indicating broad associations between the ES and various facets of psychopathology. Our results suggest that the ES may not specifically correlate with PLEs but may indicate the risk of a broader psychopathology.

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