Preterm birth or foetal growth impairment and psychiatric hospitalization in adolescence and early adulthood in a Swedish population-based birth cohort

Division of Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
Acta Psychiatrica Scandinavica (Impact Factor: 5.61). 10/2008; 119(1):54-61. DOI: 10.1111/j.1600-0447.2008.01267.x
Source: PubMed


Preterm birth and restricted foetal growth are related to symptoms of psychiatric disorder. Our aim was therefore to investigate possible relations between being born preterm and/or small for gestational age (SGA) and later psychiatric hospitalization.
A population-based registry study of psychiatric hospitalization of in total 155,994 boys and 148,281 girls born in Sweden in 1973-1975.
The risk of hospitalization for all mental disorders was increased for preterm SGA boys (OR 2.19, 95% CI 1.49-3.21); at-term SGA boys (OR 1.55, 95% CI 1.34-1.79); at-term SGA girls (OR 1.31, 95% CI 1.15-1.50). At-term SGA boys and girls suffered increased risk of anxiety and adjustment disorders (OR 1.70, 95% CI 1.18-2.45 and OR 1.49, 95% CI 1.14-1.94). Preterm SGA boys were at risk of personality disorders (OR 3.30, 95% CI 1.16-9.41) and psychotic disorders (OR 4.36, 95% CI 1.85-10.30).
The results show a relationship between being born SGA and later psychiatric hospitalization, where preterm birth and male gender seem to increase the risk.

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Available from: Ann Josefsson, Jan 15, 2014
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    • "Thereafter, we ran multivariate models where all the independent variables were entered simultaneously , in order to examine whether their effects occurred independently of each other. Since previous studies have shown that there are sex differences in the prevalence of certain mental disorders (Kessler et al. 2005; de Graaf et al. 2012: Steel et al. 2014), and in the early life risk factors for mental disorders (Monfils Gustafsson et al. 2009), sex was used as a potential confounder, and all the analyses were also repeated separately for men and women. "
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    ABSTRACT: Background: Late preterm births constitute the majority of preterm births. However, most evidence suggesting that preterm birth predicts the risk of mental disorders comes from studies on earlier preterm births. We examined if late preterm birth predicts the risks of severe mental disorders from early to late adulthood. We also studied whether adulthood mental disorders are associated with post-term birth or with being born small (SGA) or large (LGA) for gestational age, which have been previously associated with psychopathology risk in younger ages. Method: Of 12 597 Helsinki Birth Cohort Study participants, born 1934-1944, 664 were born late preterm, 1221 post-term, 287 SGA, and 301 LGA. The diagnoses of mental disorders were identified from national hospital discharge and cause of death registers from 1969 to 2010. In total, 1660 (13.2%) participants had severe mental disorders. Results: Individuals born late preterm did not differ from term-born individuals in their risk of any severe mental disorder. However, men born late preterm had a significantly increased risk of suicide. Post-term birth predicted significantly increased risks of any mental disorder in general and particularly of substance use and anxiety disorders. Individuals born SGA had significantly increased risks of any mental and substance use disorders. Women born LGA had an increased risk of psychotic disorders. Conclusions: Although men born late preterm had an increased suicide risk, late preterm birth did not exert widespread effects on adult psychopathology. In contrast, the risks of severe mental disorders across adulthood were increased among individuals born SGA and individuals born post-term.
    Full-text · Article · Sep 2014 · Psychological Medicine
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    • "While pre-and postnatal suboptimal growth has convincingly been demonstrated to be associated with physical health risks such as cardiovascular diseases (Barker 2004; Barker et al. 2005, 2009; Roseboom et al. 2006) and type 2 diabetes (Barker 2004; Barker et al. 2009; Lawlor et al. 2006; Roseboom et al. 2006), another line of evidence suggests that suboptimal growth is also related to mental health in general. Hence, suboptimal pre-and postnatal growth may also predict risk of schizophrenia (Abel et al. 2010; Byrne et al. 2007; Cannon et al. 2002; Nilsson et al. 2005; Perrin et al. 2007; Wahlbeck et al. 2001), personality disorders (Fazel et al. 2012; Lahti et al. 2010; Monfils et al. 2009), depression (Anderson et al. 2006; Brown et al. 2000; Raikkonen et al. 2007, 2008), and anxiety (Anderson et al. 2006; Levyshiff et al. 1994; Somhovd et al. 2012) as well as low adult intelligence (Eriksen et al. 2010; Richards et al. 2001, 2002). These findings are in line with the Developmental Origins of Health and Disease (DOHaD) hypothesis which suggests that a suboptimal early life environment may permanently alter developing organ structures and the functionality of biological systems and thus result in increased risk for diseases later in life (Barker 2004). "

    Full-text · Article · Jan 2014
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    • "However, epidemiological studies reveal that very-low-birthweight women and, possibly, women born preterm or very preterm have a reduced rate of giving birth, while those born SGA are, on the contrary, more likely to have given birth at an earlier age (Ekholm et al., 2005 ). Although most individuals who are born extremely preterm or with very low birthweight make an unhindered transition from childhood to adulthood with regard to self-perceived health (Gäddlin et al., 2009), it is seen in both genders that prematurity, low birthweight and intrauterine growth restriction (IUGR) can lead to neurological and psychological morbidities (Nelson, 2008; Monfils Gustafsson et al., 2009) which may also effect the probability of reproducing. Restricted fetal growth in males increases the risks of cryptorchidism , hypospadias and testicular cancer (Biggs et al., 2002; Main et al., 2006 ). "
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    ABSTRACT: The aim of this study was to investigate if individuals born with sub-optimal birth characteristics have reduced probability of reproducing in adulthood. Using population-based registries, the authors included 522 216 males and 494 692 females born between 1973 and 1983 and examined their reproductive status as of 2006. Outcome measure was the hazard ratio (HR) of reproducing. Adjustments were made for socio-economic factors. Males and females born very premature displayed a reduced probability of reproducing [HR = 0.78, 95% confidence interval (CI): 0.70-0.86 for males; HR = 0.81, CI: 0.75-0.88 for females]. Likewise for very low birthweight (HR = 0.83, CI: 0.71-0.95 for males; HR = 0.80, 95% CI: 0.72-0.89 for females). Individuals born large for gestational age (LGA) displayed no significant changes. Males born small for gestational age (SGA) had a 9% lower reproductive rate (CI: 0.89-0.94) and that reduction increased as the individuals aged. Women born SGA tended to start reproducing at an earlier age. The results suggest that being born with low birthweight, premature or SGA (for males) is associated with a reduced probability of reproducing as an adult. LGA shows no statistically significant relationship with future reproduction.
    Preview · Article · Jan 2012 · Human Reproduction
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