Prenatal and perinatal risk factors for schizophrenia, affective psychosis, and reactive psychosis of early onset: case-control study   Prenatal and perinatal risk factors for early onset schizophrenia, affective psychosis, and reactive psychosis

Hultman, Christina M.; Sparén, Pär; Takei, Noriyoshi; Murray, Robin M.; Cnattingius, Sven

doi:10.1136/bmj.318.7181.421

Cited by 309 publications

(165 citation statements)

References 36 publications

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“…An association between small head circumference at birth and the later development of schizophrenia was confirmed in a number of previous studies (Cantor-Graae et al, 1998;Hultman et al, 1999;Ichiki et al, 2000;Kunugi et al, 1996;McNeil et al, 2000). In accordance with our results, three of these studies showed a reduction in the risk related to small head circumference, after controlling for gestational age (Cantor-Graae et al, 1998;Kunugi et al, 1996;McNeil et al, 2000).…”

Section: Discussionsupporting

confidence: 80%

Fetal Growth Restriction and Schizophrenia: A Swedish Twin Study

Nilsson¹,

Stålberg

Lichtenstein

et al. 2005

Twin Res Hum Genet

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Obstetric complications increase the risk of schizophrenia. However, it is not known whether there is a causal relation or whether the association is mediated by genetic and/or shared environmental effects. The aim of this study was to investigate the associations between birthweight, other birth characteristics, and schizophrenia. Twin pairs discordant for schizophrenia will also control for unmeasured genetic and shared environmental effects. Prospectively filed obstetric records were used for a cohort analysis of 11,360 same-sexed twins, and within–twin pair analyses were conducted on 90 twin pairs discordant for schizophrenia. The results from the cohort study showed that low birthweight (less than or equal to 1999 grams; odds ratio [OR] 1.67, 95% confidence interval [CI] 0.88–3.14 and 2000–2299 grams; OR 1.79, 95% CI 1.07–3.01) and small head circumference (less than or equal to 31.5 cm; OR 1.61, 95% CI 1.03–2.51) were associated with later development of schizophrenia. The associations remained in the within-pair analyses. The association between low birthweight and schizophrenia is partly a function of reduced fetal growth. Fetal growth restriction seems to be associated with risk of schizophrenia independently of familial factors.

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Section: Discussionsupporting

confidence: 80%

Fetal Growth Restriction and Schizophrenia: A Swedish Twin Study

Nilsson¹,

Stålberg

Lichtenstein

et al. 2005

Twin Res Hum Genet

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“…In addition, a large number of epidemiological studies have demonstrated that perinatal complications, often involving fetal or neonatal hypoxia, are associated with increased risk for the development of schizophrenia (e.g., Geddes and Lawrie 1995;Jones et al 1998;Dalman et al 1999;Hultman et al 1999;Zornberg et al 2000; see review by McNeil 1995).…”

Section: Schizophrenia Is Associated With Increased Birth Complicatiomentioning

confidence: 99%

Birth Insult Alters Dopamine-Mediated Behavior in a Precocial Species, the Guinea Pig Implications for Schizophrenia

Vaillancourt

Boksa

2000

Neuropsychopharmacology

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Schizophrenia is associated with increased birth complications, suggesting that birth complications might alter CNS dopaminergic activity later in life. In rats, Caesarean section (C-section) birth can produce long term changes in dopaminergic biochemistry and behavior. However rat brain is somewhat immature compared to human brain at birth. The current study tested if mild birth complications also alter dopamine-mediated function in a species with a more mature CNS at birth, the guinea pig. As adults, guinea pigs born by C-section showed increased amphetamine-induced locomotion and disruption of prepulse inhibition (PPI) of acoustic startle, compared to vaginally born controls. Guinea pigs born by C-section withThere is considerable evidence that enhanced mesolimbic dopaminergic activity plays an important role in some of the symptomatology of schizophrenia (e.g., Laruelle et al. 1996Laruelle et al. , 1999Breier et al. 1997; AbiDargham et al. 1998; see reviews by Seeman 1992; Lieberman et al. 1997). In addition, a large number of epidemiological studies have demonstrated that perinatal complications, often involving fetal or neonatal hypoxia, are associated with increased risk for the development of schizophrenia (e.g., Geddes and Lawrie 1995;Jones et al. 1998;Dalman et al. 1999;Hultman et al. 1999;Zornberg et al. 2000; see review by McNeil 1995).Animal modelling provides the opportunity to directly test if a birth complication, such as hypoxia, can cause long term changes in dopaminergic function. Using a rat model of global hypoxia during Caesarean section (C-section) birth, several laboratories have demonstrated that dopaminergic systems are sensitive to mild birth alterations (Bjelke et al. 1991;Loidl et al. 1994;Chen et al. 1995Chen et al. , 1997 Brake et al. 1997a,b; Boksa 1997, 1998;Vaillancourt and Boksa 1998; Berger et al. 2000a). Specifically, as adults, rats born by C-section, either with or without addition of a period of global hypoxia, show increased nucleus accumbens dopamine (DA) release in response to repeated stress (Brake et al. 1997b) Vaillancourt et al. 1999), similar to the reported increased incidence of mild respiratory distress in humans born by C-section (Hales et al. 1993).In relation to the possible clinical relevance of these results, rat brain is generally believed to be somewhat less mature at birth than is the brain of the human newborn. It has been suggested that, at approximately postnatal day 10, the brain of the rat is at the stage of rapid growth, accelerated synaptogenesis, myelinization, and astrocyte proliferation characteristic of the human newborn at term (see review by Romijn et al. 1991). Thus, the model of birth insult in the rat may relate more to premature than to term human brain. To circumvent this limitation, we initiated the current studies to test if mild birth complications also alter DA mediated function in a species with a more mature CNS at birth. The guinea pig is a precocial species, that is, capable of a high degree of independent activity at birth....

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“…Obstetric and neonatal complications may have a long-term influence on offspring mental health, including risks of schizophrenia [7], depression [8], and suicidal acts [9][10][11][12]. Maternal smoking has been recognized as one of the most important risk factors for adverse pregnancy outcomes, including placental complications, fetal growth restriction, preterm birth and associated conditions [13].…”

Section: Introductionmentioning

confidence: 99%

Maternal smoking during pregnancy and risks of suicidal acts in young offspring

et al. 2011

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Word count (excluding title page, abstract, references and tables): 2,976. 2 AbstractObstetric and neonatal complications have been associated with completed and attempted suicide (suicidal acts) in young offspring. Maternal smoking is one of the most important risk factors for obstetric complications, but the association between prenatal smoking exposure and offspring risk of suicidal acts is unknown.We performed a population-based study of 1 449,333 single births born in Sweden between 1983 and 1996, derived from linked registry data. Maternal smoking and risks of suicidal acts in offspring were estimated using hazard ratios, derived from proportional-hazard models, controlling for potential confounding of parental socio-demographic factors and psychiatric care in first degree relatives. To control for unmeasured familial confounding, a matched case-control analysis of suicidal acts was performed within sibling pairs discordant for prenatal smoking exposure.In the cohort analysis, the adjusted hazard ratio for completed suicide among offspring to women smoking 1-9 cigarettes and at least 10 cigarettes per day were 1.67, 95% confidence interval (CI), 1.29-2.16, and 1.54, 95% CI, 1.12-2.10. For suicidal acts, corresponding hazard ratios were 1.28, 95% CI 1.21-1.35 and 1.48, 95% CI 1.39-1.57, respectively. However, in sibling pairs discordant for suicidal acts and prenatal smoking exposure, we found no evidence that prenatal smoking exposure increased the risk of suicidal acts. We conclude that the association between prenatal smoking exposure and offspring risk of suicidal acts is probably confounded by unmeasured familial factors.Word count: 230

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Prenatal and perinatal risk factors for schizophrenia, affective psychosis, and reactive psychosis of early onset: case-control study Prenatal and perinatal risk factors for early onset schizophrenia, affective psychosis, and reactive psychosis

Abstract: Objective To examine prenatal and perinatal risk factors for subsequent development of schizophrenia and affective and reactive psychosis.

Cited by 309 publications

References 36 publications

Fetal Growth Restriction and Schizophrenia: A Swedish Twin Study

Fetal Growth Restriction and Schizophrenia: A Swedish Twin Study

Birth Insult Alters Dopamine-Mediated Behavior in a Precocial Species, the Guinea Pig Implications for Schizophrenia

Maternal smoking during pregnancy and risks of suicidal acts in young offspring

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