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The effect of obstetric complications on the risk of schizophrenia: A twin study
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A.78. THE EFFECT OF OBSTETRIC COMPLICATIONS ON THE RISK OF SCHIZOPHRENIA: A TWIN STUDY C.J. van Oel, M.M. Sitskoorn, W. Geurtsen, R.S. K a h n Department of Psychiatry, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. Tel: +31 30 2507121; Fax." +31 302505443. E-mail: C.J. [email protected] Instead of focusing on specific obstetric complications that might increase the risk of schizophrenia, attention has shifted towards the underlying mechanisms, i.e. fetal malnutrition, prematurity, and hypoxia/ischemia (Dalman, 1999). For 31 ( 18 MZ, 13 DZ) pairs of control twins and 38 ( 13 MZ, 25 DZ) pairs of twins discordant for schizophrenia, the McNeilSj6str6m Scale was used to rate the severity of pregnancy, labor and delivery, and neonatal complications. Logistic regression was conducted to analyse whether discordant and control twins were equally affected by obstetric complications. Conditional logistic regression was used to analyse differences between the twin with schizophrenia and the unaffected co-twin. The final logistic regression model included 3 factors that were univariate significant: DZ discordant twins had marginally more pregnancy complications (i.e. maternal disorders) during the third trimester than DZ control twins (adjusted OR = 1.41; p--0.09). Full-term born discordant twins had larger intrapair differences in labor and delivery complications (i.e. instrumental delivery) (adjusted OR: 2.2; p<0.05) and neonatal complications (i.e. gastro-intestinal and general disorders) than control twins (adjusted OR: 1,8; p<0.05). In full-term born twins with neonatal complications, the conditional OR to develop schizophrenia was 2.6 (p <0.05). In full-term delivered twins, neonatal complications are associated with an increased risk of schizophrenia. Fetal growth retardation respectively perinatal asphyxia might further increase this risk by inducing a poor neonatal condition.
A.79. L O W M A T E R N A L B O D Y M A S S INDEX, SMALL SIZE AT BIRTH AND THINNESS DURING CHILDHOOD ARE ASSOCIATED WITH SCHIZOPHRENIA: A POPULATION BASED COHORT STUDY K. Wahlbeck, T. Fors6n, C. Osmond, D.J.P. Barker, J.G. Eriksson
Helsinki University Central Hospital from 1924 to 1933. Prospectively gathered data from birth and school health records of 7086 individuals were collected and linked to the Finnish Hospital Discharge Register. One hundred fourteen individuals were found to have been diagnosed with schizophrenia or schizoaffecting disorder. A low maternal body mass index increased the risk (OR 0.92 per kg/m 2, p=0.01) for schizophrenia among the offspring. The risk of schizophrenia increased with low birth weight (OR 0.67 per kg, p=0.03), shortness at birth (OR 0.89 per cm, p = 0.009), and low placental weight (OR 0.13 per kg, p=0.01). Schizophrenia cases were thinner than comparison subjects from 7 to 15 years of age. In a joint model comprising maternal BMI, body size at birth, and childhood BMI, childhood BMI was an independent predictor of schizophrenia while effects of the other factors were attenuated. The authors conclude that intrauterine and childhood undernutrition increase lifetime risk of schizophrenia.
A.80. LABOUR AND DELIVERY COMPLICATIONS AT BIRTH AND LATER MANIA; AN IRISH CASE REGISTER STUDY R. Browne, M. Byrne, N. Mulryan, A. Scully, M. Morris, A. Kinsella, T.F. McNeill, D. Walsh, E. O'Callaghan Stanley Foundation Research Unit, St. John of God Adult Psychiatric Service. Cluain Mhuire Family Centre. Newtownpark Avenue, County Dublin, Ireland Objective: To compare the rate of labour and delivery complications of persons who later develop mania with controls. Method: From the Dublin Psychiatric Case Register we identified individuals with a discharge diagnosis of mania and traced their birth records. Each case was matched with a control of the same gender, born in the same hospital, in the same year, matched for maternal age, parity and social class. Two obstetric complication scales were used blindly to evaluate labour and delivery data. Results: We found no increase in the frequency or the severity of labour and delivery complications of manics compared to their matched controls. Obstetric adversity was unrelated to the age at first presentation to psychiatric services. Conclusion: These findings suggest that obstetric adversity is not a risk factor for later mania.
Dept. of Psychiatry. University of HelsinkL PB 320, FIN-O0029 HUCH, Finland It has been postulated that nutritional factors in early life may contribute to the neurodevelopmental deficit in schizophrenia. This study was undertaken to explore the influence of maternal body size, size at birth, and childhood growth on future risk for schizophrenia. This population based cohort study comprised births at
A.81. NEONATAL HYPERBILIRUBINEMIA A VULNERABILITY FACTOR FOR MENTAL DISORDER? -
C. Dalman, J. Cullberg
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A.78. THE EFFECT OF OBSTETRIC COMPLICATIONS ON THE RISK OF SCHIZOPHRENIA: A TWIN STUDY C.J. van Oel, M.M. Sitskoorn, W. Geurtsen, R.S. K a h n Department of Psychiatry, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. Tel: +31 30 2507121; Fax." +31 302505443. E-mail: C.J. [email protected] Instead of focusing on specific obstetric complications that might increase the risk of schizophrenia, attention has shifted towards the underlying mechanisms, i.e. fetal malnutrition, prematurity, and hypoxia/ischemia (Dalman, 1999). For 31 ( 18 MZ, 13 DZ) pairs of control twins and 38 ( 13 MZ, 25 DZ) pairs of twins discordant for schizophrenia, the McNeilSj6str6m Scale was used to rate the severity of pregnancy, labor and delivery, and neonatal complications. Logistic regression was conducted to analyse whether discordant and control twins were equally affected by obstetric complications. Conditional logistic regression was used to analyse differences between the twin with schizophrenia and the unaffected co-twin. The final logistic regression model included 3 factors that were univariate significant: DZ discordant twins had marginally more pregnancy complications (i.e. maternal disorders) during the third trimester than DZ control twins (adjusted OR = 1.41; p--0.09). Full-term born discordant twins had larger intrapair differences in labor and delivery complications (i.e. instrumental delivery) (adjusted OR: 2.2; p<0.05) and neonatal complications (i.e. gastro-intestinal and general disorders) than control twins (adjusted OR: 1,8; p<0.05). In full-term born twins with neonatal complications, the conditional OR to develop schizophrenia was 2.6 (p <0.05). In full-term delivered twins, neonatal complications are associated with an increased risk of schizophrenia. Fetal growth retardation respectively perinatal asphyxia might further increase this risk by inducing a poor neonatal condition.
A.79. L O W M A T E R N A L B O D Y M A S S INDEX, SMALL SIZE AT BIRTH AND THINNESS DURING CHILDHOOD ARE ASSOCIATED WITH SCHIZOPHRENIA: A POPULATION BASED COHORT STUDY K. Wahlbeck, T. Fors6n, C. Osmond, D.J.P. Barker, J.G. Eriksson
Helsinki University Central Hospital from 1924 to 1933. Prospectively gathered data from birth and school health records of 7086 individuals were collected and linked to the Finnish Hospital Discharge Register. One hundred fourteen individuals were found to have been diagnosed with schizophrenia or schizoaffecting disorder. A low maternal body mass index increased the risk (OR 0.92 per kg/m 2, p=0.01) for schizophrenia among the offspring. The risk of schizophrenia increased with low birth weight (OR 0.67 per kg, p=0.03), shortness at birth (OR 0.89 per cm, p = 0.009), and low placental weight (OR 0.13 per kg, p=0.01). Schizophrenia cases were thinner than comparison subjects from 7 to 15 years of age. In a joint model comprising maternal BMI, body size at birth, and childhood BMI, childhood BMI was an independent predictor of schizophrenia while effects of the other factors were attenuated. The authors conclude that intrauterine and childhood undernutrition increase lifetime risk of schizophrenia.
A.80. LABOUR AND DELIVERY COMPLICATIONS AT BIRTH AND LATER MANIA; AN IRISH CASE REGISTER STUDY R. Browne, M. Byrne, N. Mulryan, A. Scully, M. Morris, A. Kinsella, T.F. McNeill, D. Walsh, E. O'Callaghan Stanley Foundation Research Unit, St. John of God Adult Psychiatric Service. Cluain Mhuire Family Centre. Newtownpark Avenue, County Dublin, Ireland Objective: To compare the rate of labour and delivery complications of persons who later develop mania with controls. Method: From the Dublin Psychiatric Case Register we identified individuals with a discharge diagnosis of mania and traced their birth records. Each case was matched with a control of the same gender, born in the same hospital, in the same year, matched for maternal age, parity and social class. Two obstetric complication scales were used blindly to evaluate labour and delivery data. Results: We found no increase in the frequency or the severity of labour and delivery complications of manics compared to their matched controls. Obstetric adversity was unrelated to the age at first presentation to psychiatric services. Conclusion: These findings suggest that obstetric adversity is not a risk factor for later mania.
Dept. of Psychiatry. University of HelsinkL PB 320, FIN-O0029 HUCH, Finland It has been postulated that nutritional factors in early life may contribute to the neurodevelopmental deficit in schizophrenia. This study was undertaken to explore the influence of maternal body size, size at birth, and childhood growth on future risk for schizophrenia. This population based cohort study comprised births at
A.81. NEONATAL HYPERBILIRUBINEMIA A VULNERABILITY FACTOR FOR MENTAL DISORDER? -
C. Dalman, J. Cullberg
-