Obstetric complications and schizophrenia: A case control study based on standarised obstetric records

University of Edinburgh.
The British Journal of Psychiatry (Impact Factor: 7.99). 05/1996; 168(5):556-61. DOI: 10.1192/bjp.168.5.556
Source: PubMed


There have been many reports of a higher incidence of 'obstetric complications' in the histories of schizophrenics than of controls, but because of the methodological shortcomings of most of these comparisons the relationship remains controversial.
Comprehensive records covering all psychiatric hospital admissions and all hospital deliveries in Scotland since 1971 made it possible to identify the obstetric records of people born in 1971-74 who were subsequently admitted to hospital with a diagnosis of schizophrenia, and then to compare their standardised obstetric records with those of closely matched controls.
One hundred and fifteen schizophrenic/control pairs were compared. The former showed a highly significant (P < 0.001) excess of complications of both pregnancy and delivery. In particular, there was a significant excess of pre-eclampsia (10 v. 2) and of infants detained in hospital for neonatal care (18 v. 6).
The raised incidence of obstetric complications often reported in people with schizophrenia is genuine and probably contributes to the aetiology of the condition.

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    • "Interestingly many schizophrenia susceptibility genes are regulated by hypoxia, suggesting close interactions among IO&NS genes and obstetric complications leading to enhanced risk of schizophrenia (Nicodemus et al., 2008; Schmidt-Kastner et al., 2006). Other conditions of pregnancy, including hypoxia associated preeclampsia (Kendell et al., 1996), also increase the risk of the offspring being classed as having schizophrenia, emphasizing the profound impact of prenatal events. "
    Progress in Neuro-Psychopharmacology and Biological Psychiatry 10/2012; 42. DOI:10.1016/j.pnpbp.2012.10.008 · 3.69 Impact Factor
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    • "cant risk factor , there was evidence of increased risk associated with all three etiologic mechanisms ( Dalman et al . 1999 ) . Another study by Kendell et al . showed that pregnancy and birth complications ( PBC ) , especially pre - eclampsia and infants detained for neonatal care , were common among schizophrenic patients compared to controls ( Kendell et al . 1996 ) . An interesting link was found between prenatal nutritional deficiency and increased risk for schizophrenia ( Susser et al . 1996 ) ."
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    • "One possibility is that female fetuses are more likely to survive the putative effects of HLA-B matching, such as preeclampsia [119] and hence to be observed in a study, than male offspring. Although the sex-dependent finding is intriguing in light of the work demonstrating that RHD maternal-fetal genotype incompatibility as a schizophrenia risk factor is limited to males [67], replication and investigation of hypothesized clinical manifestations of HLA-B matching (low birth weight, preeclampsia, other complications) are warranted because other published studies reveal conflicting results regarding sex differences in the rates of low birth weight and preeclampsia among individuals with schizophrenia [102] [104]. Because the firstborn child of a couple is at highest risk for preeclampsia, one could also seek further evidence in support of an HLA-B matching—preeclampsia relationship by testing for a birth order effect. "
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