Paula Rantakallio

University of Oulu, Uleoborg, Oulu, Finland

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Publications (102)293.5 Total impact

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    ABSTRACT: This study examined the association between infant developmental milestones and educational level at 31 years of age in the Northern Finland 1966 Birth Cohort (n = 12 058). Developmental data (age at standing, walking, speaking, and measures of bowel and bladder control) were gathered from children's welfare centres. Information on type of schooling at 14 years of age was reported by children and parents. School achievement at 16 years of age and educational level at 31 years were obtained from national registers. Those who reached infant developmental milestones sooner in their first year of life had significantly better (p < 0.05) mean scores in teacher ratings at 16 years, and at 31 years they were more likely to have achieved a better educational level than slower developers. The adjusted odds ratios for individuals who developed more slowly to remain at a basic educational level (7 to 16y) ranged significantly from 1.1 to 1.3. The possibility of advancing from secondary to tertiary level was 1.4 times greater in faster developers than in slow developers. In conclusion, those who develop faster during their first year of life tend to attain higher levels of education in adolescence and adulthood.
    Developmental Medicine & Child Neurology 10/2005; 47(9):581-6. DOI:10.1017/S0012162205001155
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    ABSTRACT: The aim was to study how many of the individuals with intellectual disability (ID; IQ < or = 70) in an age cohort were not receiving a disability pension by the age of 34 years and what their life situation was like in terms of employment, education and morbidity. In 2000, the Northern Finland 1966 Birth Cohort (n=12,058 live-born) included 129 individuals with ID. The outcome data on employment, education, pensions and morbidity were obtained from national registers. A total of 85.3% (n=110) of all the individuals with ID were on pension, and 66 of them had severe ID (IQ <50) and 44 had mild ID (IQ 50-70). Altogether 99 were drawing a pension because of ID, and 11 had a main diagnosis other than ID in the register of Social Insurance Institution. Nineteen individuals with mild ID were not on disability pension. The educational level of those without pension was low, and all whose occupation was known worked in low-level manual trades in the open labour market. During the past 8 years (1993-2000), their employment rate had been lower and unemployment rate correspondingly higher and unemployment periods longer than those of the reference group (IQ >85 or not measured). As to the morbidity, they had been hospitalized twice more often than those in the reference group and the mean of their hospitalization days was over fourfold. More attention should be paid to the vocational education and supported employment services of individuals with ID to help them to manage as independently as possible.
    Journal of Intellectual Disability Research 03/2005; 49(Pt 3):218-27. DOI:10.1111/j.1365-2788.2005.00648.x
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    ABSTRACT: Data on the birth weight-blood pressure relationship are inconsistent. Although an inverse association has been suggested in several large studies, interpretation is complicated by publication and other biases. Few data are available on the relationship between other early growth measures and blood pressure. We examined the shape and size of association between determinants of fetal growth, size at birth, growth in infancy, and adult systolic and diastolic blood pressure at 31 years in the prospective northern Finnish 1966 birth cohort of 5960 participants. Birth weight, birth length, gestational age, ponderal index, and birth weight relative to gestational age showed a significant inverse association with blood pressure at age 31. Rapid growth in infancy ("change-up") was positively associated with blood pressure. Adjusted regression coefficients for birth weight indicated systolic/diastolic blood pressure lower by -1.7 (95% confidence interval [CI], -2.5, -1.0)/-0.7 (95% CI, -1.4, -0.02) mm Hg for 1 kg higher birth weight. The significant inverse association between birth weight and systolic blood pressure persisted without adjustment for adult body mass index for males. Among females, gestational age showed a stronger association with blood pressure than birth weight: gestational age higher by 7 weeks (equivalent to an average of 1 kg higher birth weight) among singletons associated with -2.9 (95% CI, -4.7, -1.1) mm Hg lower systolic blood pressure. Our results support the concept that birth weight, other birth measures, and infant growth are important determinants of blood pressure and hence cardiovascular disease risk in later life.
    Hypertension 01/2005; 44(6):838-46. DOI:10.1161/
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    ABSTRACT: Central nervous system (CNS) viral infections have been suggested to increase the risk of schizophrenia, although most of the evidence is indirect and comes from rather few studies on exposure to various infections in general. In the Northern Finland 1966 Birth Cohort the association between schizophrenia and other psychoses and childhood CNS infections has been analysed, and in this paper we present the follow-up results up to the end of 1994 and 1997. Data regarding the infections were collected prospectively between 1966-1980 and data on psychoses from 1982. The registered psychiatric diagnoses were validated using the DSM-III-R classification. Out of the 11017 subjects (96% of all births in that year) 145 had suffered a CNS infection during childhood, which in 102 cases was a viral infection. In the follow-up to the end of 1994, 76 had schizophrenia, and their number increased to 100 to the end of 1997. In addition, up to the end of 1994, 52 patients had a non-schizophrenic psychosis. Four cases in the schizophrenia patient group and none of the patients with other psychosis had suffered a viral CNS infection. None of the schizophrenia cases and two of the patients with other psychosis had had a bacterial infection. The adjusted odds ratio for schizophrenia after a viral CNS infection was 4.8 (95% confidence intervals [CI] 1.6-14.0) in the follow-up to the end of 1994 and 2.5 (0.9-7.0) in the follow-up to the end of 1997. The clinical course variables did not differ between the schizophrenia patients with or without CNS infection. Our results suggest that viral CNS infections during childhood may have a role as a risk factor for schizophrenia. Their role may be modest at the population level due to their relative rareness.
    European Archives of Psychiatry and Clinical Neuroscience 03/2004; 254(1):9-13. DOI:10.1007/s00406-004-0485-2
  • Schizophrenia Research 02/2004; 66(1):79-81. DOI:10.1016/S0920-9964(02)00437-1
  • Schizophrenia Research 03/2003; 60(1):44-44. DOI:10.1016/S0920-9964(03)80130-5
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    ABSTRACT: Delayed childhood development may precede adult psychoses. We tested this hypothesis in a large, general population birth cohort (n=12058) followed to age 31 years. The ages at which individuals learned to stand, walk, speak, and became potty-trained (bowel control) and dry (bladder control), were recorded at a 1-year examination. Psychiatric outcome was ascertained through linkage to a national hospital discharge register. Cumulative incidence of DSM-III-R schizophrenia, other psychoses and non-psychotic disorders were stratified according to the timing of milestones and compared within the cohort using internal standardization. 100 cases of DSM-III-R schizophrenia, 55 other psychoses, and 315 non-psychotic disorders were identified. The ages at learning to stand, walk and become potty-trained were each related to subsequent incidence of schizophrenia and other psychoses. Compared with the whole cohort, earlier milestones reduced, and later milestones increased, the risk in a linear manner. These developmental effects were not seen for non-psychotic outcomes. The findings support hypotheses regarding psychosis as having a developmental dimension with precursors apparent in early life.
    Schizophrenia Research 11/2001; 52(1-2):1-19. DOI:10.1016/S0920-9964(00)00179-1
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    ABSTRACT: To investigate the association between juvenile and early adult cigarette smoking and educational achievements up to the age of 31 years. As a part of the follow-up of the North Finland 1966 Birth Cohort (n = 10542) from 1966 to 1997, smoking was assessed at the ages of 14 and 31 by postal questionnaires. The highest level of educational attainment was obtained from the National Education Registry of Statistics Finland up to the age of 31 years. Adult smoking (at age 31) and prolonged smoking (at ages 14 and 31) were both associated with an approximately two- to sixfold, adjusted odds for educational underachievement. Smoking only at age 14 showed none of these associations. These results are unlikely to be causal, but may be explained by other characteristics associated with smoking such as personality or lifestyle factors, as well as the effect of knowledge related to smoking gained during higher education.
    Scandinavian Journal of Public Health 07/2001; 29(2):87-95. DOI:10.1177/14034948010290020501
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    ABSTRACT: Mental disorders often begin during the formative years of education. They may disrupt education and lead to social underachievement. We examined the impact of mental disorders treated in hospital (ages 16-29) on educational attainment up to 31 years in the Northern Finland 1966 Birth Cohort (N = 10581). People discharged due to mental illness were grouped by DSM-III-R diagnoses (of schizophrenia, other psychoses and non-psychotic disorders) and were compared with those having no such hospital treatment. Associations between diagnoses and educational outcome (completion of basic level, upper secondary or tertiary education) were analysed stratified by age at onset (early onset < 22 years v. later), and adjusted for confounding by perinatal risk, early motor development, maternal education, family structure, parental social class, and school achievement using prospective data from earlier assessments and logistic regression analysis. Twelve per cent of the comparison group completed basic level education, 62% upper secondary, and 26% tertiary education. People with early onset disorder tended to stagnate in the basic level. Early onset schizophrenia and all non-psychotic cases had 3- to 6-fold adjusted odds for this outcome. Many with early onset schizophrenia completed secondary education, but none completed the tertiary level. Hospitalization for non-psychotic disorder increased the risk of underachievement in tertiary education for those with early onset. Mental disorder treated in hospital truncates education. Failure to complete higher education may contribute to the 'social exclusion' of the mentally ill through reduced opportunities in later occupational life and failure to accumulate social capital.
    Psychological Medicine 03/2001; 31(2):339-49. DOI:10.1017/S003329170100304X
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    ABSTRACT: Subtle motor, emotional, cognitive and behavioral abnormalities are often present in apparently healthy children and adolescents who later develop schizophrenia. This suggests that some aspects of causation are established long before psychosis is manifest. We aim to develop a descriptive model of the factors contributing to the development of schizophrenia. Our main focus is on genetic factors, pregnancy and delivery complications, early development and scholastic performance. This is done by reviewing the Northern Finland 1966 Birth Cohort, its scientific activities (publications and work in progress) and selected literature.
    European Archives of Psychiatry and Clinical Neuroscience 02/2000; 250(6):311-9. DOI:10.1007/s004060070006
  • Schizophrenia Research 01/2000; 41(1):70-70. DOI:10.1016/S0920-9964(00)90460-2
  • Schizophrenia Research 01/2000; 41(1):80-81. DOI:10.1016/S0920-9964(00)90490-0
  • Schizophrenia Research 01/2000; 41(1):83-83. DOI:10.1016/S0920-9964(00)90496-1
  • P Zitting, P Rantakallio, H Vanharanta
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    ABSTRACT: A cohort study of 12,000 persons with a follow-up period ranging from birth to the age of 28 years. To determine the cumulative incidence of lumbar disc disease leading to hospitalization in a well-defined geographic population, with special emphasis on age of onset and differences between the genders and among disease categories. There are few published reports on low back pain in adolescence, and most of them are cross-sectional in design. The Finnish National Hospital Discharge Register was used to identify all possible cases of lumbar disc disease. Copies of all hospital records regarding the diagnosis and course of the disease were collected and the hospitalizations were classified into three categories: 1) confirmed herniated nucleus pulposus (HNP), 2) unconfirmed HNP (sciatica symptoms without visible herniation), and 3) other low back diseases. The patients were classified according to the highest category of diagnosis achieved by each. Symptomatic low back pain leading to hospitalization first appeared around the age of 15 years, and the incidence rose more sharply from the age of 19, especially in men with other low back diseases. Men were hospitalized more than twice as often as women. Lumbar disc diseases leading to hospitalization begin early.
    Spine 12/1998; 23(21):2337-43; discussion 2343-4. DOI:10.1097/00007632-199811010-00017
  • B Xu, P Rantakallio, M R Järvelin
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    ABSTRACT: We followed 11,355 children born in 1966 up to the age of 24 years to investigate the impact of birthweight on long-term outcomes of death and development. As expected, low-birthweight (LBW, 1500-2,499 gm) children showed a higher risk of death than normal-birthweight (NBW, > or =2,500 gm) children before the age of 15 years. Rate ratios for LBW children ranged from 25 for the first week of life to 2.5 for ages 5-14 years. Rate ratios of very-low-birthweight (VLBW, <1,500 gm) children for the first year of life were 10 times higher than those of LBW children. Similarly, for the first 14 years of life, surviving LBW children experienced a higher risk of being hospitalized as well as staying in hospitals for over 2 weeks if they were hospitalized. The LBW children still had a higher risk of receiving sick pensions at the age of 24 years.
    Epidemiology 11/1998; 9(6):662-5.
  • Archives of General Psychiatry 11/1998; 55(10):949. DOI:10.1001/archpsyc.55.10.949
  • Baizhuang Xu, Paula Rantakallio, Marjo-Riitta Jãrvelin
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    ABSTRACT: We followed 11,355 children born in 1966 up to the age of 24 years to investigate the impact of birthweight on long-term outcomes of death and development. As expected, low-birthweight (LBW, 1500-2,499 gm) children showed a higher risk of death than normal-birthweight (NBW, greater than or equal to 2,500 gm) children before the age of 15 years. Rate ratios for LBW children ranged from 25 for the first week of life to 2.5 for ages 5-14 years. Rate ratios of very-low-birthweight (VLBW, <1,500 gm) children for the first year of life were 10 times higher than those of LBW children. Similarly, for the first 14 years of life, surviving LBW children experienced a higher risk of being hospitalized as well as staying in hospitals for over 2 weeks if they were hospitalized. The LBW children still had a higher risk of receiving sick pensions at the age of 24 years.
    Epidemiology 11/1998; 9(6):662-665. DOI:10.1097/00001648-199811000-00017
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    ABSTRACT: The sex difference in perinatal mortality in developed countries is largely unexplained. The current study evaluated the differences in the impact of maternal smoking during pregnancy on the risk of perinatal death between males and females. The analysis involved 11,469 and 9,404 newborns derived from two population-based birth cohorts in Northern Finland, for 1966 and 1985-86, respectively. The perinatal mortality rate was 23 per thousand in the 1966 cohort and 9 per thousand in the 1985-86 cohort. The rate ratio (RR) for mortality for males over females is 1.15 and 1.60 in the two cohorts, respectively. Among children whose mothers smoked during pregnancy, the RR was 2.2 (95% CI 1.0, 4.7) for the former cohort and 4.8 (95% CI 1.5, 15.2) for the later cohort; and among the children whose mothers did not smoke the corresponding RR was 1.2 (95% CI 0.9, 1.6) and 1.1 (95% CI 0.6, 1.9). Maternal smoking during pregnancy could be an important determinant accounting for the excess perinatal death for males over females. Our results encourage evaluation of the findings among other populations.
    Social biology 09/1998; 45(3-4):273-7. DOI:10.1080/19485565.1998.9988978
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    ABSTRACT: Deterioration in school achievement may pre-date adult mental disorders. We studied the association between compulsory school performance and later onset hospital-treated psychiatric morbidity experienced by the Northern Finland 1966 Birth Cohort (N = 11017) in adult life. School performance was operationalized in two ways: school class level (in normal, i.e. age-appropriate class v. not in normal class, i.e. class below age level or in special school) at the age of 14, and marks for individual school subjects at the age of 16. School class level was ascertained by postal questionnaire and school marks from national application register. These were linked to data on psychiatric morbidity from the National Finnish Hospital Discharge Register. By the end of 1994 (between ages 16 and 28 years), a total of 383 subjects had psychiatric illness. DSM-III-R diagnoses were grouped into three categories: schizophrenia; other psychoses; and non-psychotic disorders. The remaining population with no psychiatric hospitalization served as a single comparison group. School class level and values of school marks in the three diagnostic categories were each compared with this comparison group, stratified by sex. In the comparison group 6.8% of boys and 3.4% of girls were not in their normal class. In all the diagnosis groups the proportions of those not in normal class were from 2 to 8 times higher than in the comparison group. A majority of those not in normal class and having psychiatric diagnosis were intellectually subnormal (IQ < 85). Among adolescents who later developed nonpsychotic disorders, means of school marks were lower (P < 0.05, adjusted for social class and place of residence) than in the comparison group. Lower marks were not found in categories schizophrenia or other psychoses. Logistic regression analysis confirmed these findings after adjustment for confounding factors. Not being in the normal class at age 14 predicted future hospital-treated disorders, but low school marks at age 16 predicted only non-psychotic disorders. These findings may be an early manifestation of the disorders themselves, or a marker of vulnerability or other risk factors. The mechanisms may differ between diagnoses.
    Psychological Medicine 08/1998; 28(4):967-74. DOI:10.1017/S0033291798006928

Publication Stats

3k Citations
293.50 Total Impact Points


  • 1978–2005
    • University of Oulu
      • • Department of Public Health Science and General Practice
      • • Department of Psychiatry
      • • Department of Paediatrics
      Uleoborg, Oulu, Finland
  • 1998
    • National Public Health Institute
      Helsinki, Southern Finland Province, Finland
  • 1997
    • University of Nottingham
      Nottigham, England, United Kingdom
    • Qingdao University
      • Medical College
      Tsingtao, Shandong Sheng, China