Increased Risk of Schizophrenia From Additive Interaction Between Infant Motor Developmental Delay and Obstetric Complications: Evidence From a Population-Based Longitudinal Study
Objective:Obstetric complications and developmental delay are well-established risk factors for schizophrenia. The authors investigated whether these risk factors interact in an additive manner to further increase risk for schizophrenia. Method:The study population encompassed all individuals born i...
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| Published in | The American journal of psychiatry Vol. 168; no. 12; pp. 1295 - 1302 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Arlington, VA
American Psychiatric Publishing
01.12.2011
American Psychiatric Association |
| Subjects | |
| Online Access | Get full text |
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| Abstract | Objective:Obstetric complications and developmental delay are well-established risk factors for schizophrenia. The authors investigated whether these risk factors interact in an additive manner to further increase risk for schizophrenia.
Method:The study population encompassed all individuals born in Helsinki between 1962 and 1969 who had developmental records archived in the Helsinki City Archives. Through linkage between the Finnish Population Register, the Finnish Hospital Discharge Register, and the Child Health Archives, child health cards were traced for 189 individuals who had received a diagnosis of schizophrenia and 189 healthy comparison subjects, individually matched to case subjects on gender and year of birth. Child health cards from the Child Health Archives contain detailed prospective developmental data from birth as well as an indicator of fetal distress, as measured by the Apgar score. Detailed developmental data from the first year of life were extracted.
Results:Delayed attainment of milestones in infancy significantly increased the risk of later development of schizophrenia in a dose-response manner. There was no significant main effect of obstetric complications on risk for schizophrenia and no significant association between obstetric complications and subsequent developmental delay. However, the additive effect of obstetric complications and delayed attainment of developmental milestones significantly increased the risk of schizophrenia beyond that associated with each factor independently (odds ratio=4.6, 95% confidence interval=1.3–17.2).
Conclusions:These data provide evidence that underlying neurodevelopmental vulnerability, as indexed by delayed attainment of milestones, combined with obstetric adversity significantly increases the risk of schizophrenia in adulthood. |
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| AbstractList | Obstetric complications and developmental delay are well-established risk factors for schizophrenia. The authors investigated whether these risk factors interact in an additive manner to further increase risk for schizophrenia.
The study population encompassed all individuals born in Helsinki between 1962 and 1969 who had developmental records archived in the Helsinki City Archives. Through linkage between the Finnish Population Register, the Finnish Hospital Discharge Register, and the Child Health Archives, child health cards were traced for 189 individuals who had received a diagnosis of schizophrenia and 189 healthy comparison subjects, individually matched to case subjects on gender and year of birth. Child health cards from the Child Health Archives contain detailed prospective developmental data from birth as well as an indicator of fetal distress, as measured by the Apgar score. Detailed developmental data from the first year of life were extracted.
Delayed attainment of milestones in infancy significantly increased the risk of later development of schizophrenia in a dose-response manner. There was no significant main effect of obstetric complications on risk for schizophrenia and no significant association between obstetric complications and subsequent developmental delay. However, the additive effect of obstetric complications and delayed attainment of developmental milestones significantly increased the risk of schizophrenia beyond that associated with each factor independently (odds ratio=4.6, 95% confidence interval=1.3-17.2).
These data provide evidence that underlying neurodevelopmental vulnerability, as indexed by delayed attainment of milestones, combined with obstetric adversity significantly increases the risk of schizophrenia in adulthood. Obstetric complications and developmental delay are well-established risk factors for schizophrenia. The authors investigated whether these risk factors interact in an additive manner to further increase risk for schizophrenia.OBJECTIVEObstetric complications and developmental delay are well-established risk factors for schizophrenia. The authors investigated whether these risk factors interact in an additive manner to further increase risk for schizophrenia.The study population encompassed all individuals born in Helsinki between 1962 and 1969 who had developmental records archived in the Helsinki City Archives. Through linkage between the Finnish Population Register, the Finnish Hospital Discharge Register, and the Child Health Archives, child health cards were traced for 189 individuals who had received a diagnosis of schizophrenia and 189 healthy comparison subjects, individually matched to case subjects on gender and year of birth. Child health cards from the Child Health Archives contain detailed prospective developmental data from birth as well as an indicator of fetal distress, as measured by the Apgar score. Detailed developmental data from the first year of life were extracted.METHODThe study population encompassed all individuals born in Helsinki between 1962 and 1969 who had developmental records archived in the Helsinki City Archives. Through linkage between the Finnish Population Register, the Finnish Hospital Discharge Register, and the Child Health Archives, child health cards were traced for 189 individuals who had received a diagnosis of schizophrenia and 189 healthy comparison subjects, individually matched to case subjects on gender and year of birth. Child health cards from the Child Health Archives contain detailed prospective developmental data from birth as well as an indicator of fetal distress, as measured by the Apgar score. Detailed developmental data from the first year of life were extracted.Delayed attainment of milestones in infancy significantly increased the risk of later development of schizophrenia in a dose-response manner. There was no significant main effect of obstetric complications on risk for schizophrenia and no significant association between obstetric complications and subsequent developmental delay. However, the additive effect of obstetric complications and delayed attainment of developmental milestones significantly increased the risk of schizophrenia beyond that associated with each factor independently (odds ratio=4.6, 95% confidence interval=1.3-17.2).RESULTSDelayed attainment of milestones in infancy significantly increased the risk of later development of schizophrenia in a dose-response manner. There was no significant main effect of obstetric complications on risk for schizophrenia and no significant association between obstetric complications and subsequent developmental delay. However, the additive effect of obstetric complications and delayed attainment of developmental milestones significantly increased the risk of schizophrenia beyond that associated with each factor independently (odds ratio=4.6, 95% confidence interval=1.3-17.2).These data provide evidence that underlying neurodevelopmental vulnerability, as indexed by delayed attainment of milestones, combined with obstetric adversity significantly increases the risk of schizophrenia in adulthood.CONCLUSIONSThese data provide evidence that underlying neurodevelopmental vulnerability, as indexed by delayed attainment of milestones, combined with obstetric adversity significantly increases the risk of schizophrenia in adulthood. Objective: Obstetric complications and developmental delay are well-established risk factors for schizophrenia. The authors investigated whether these risk factors interact in an additive manner to further increase risk for schizophrenia. Method: The study population encompassed all individuals born in Helsinki between 1962 and 1969 who had developmental records archived in the Helsinki City Archives. Through linkage between the Finnish Population Register, the Finnish Hospital Discharge Register, and the Child Health Archives, child health cards were traced for 189 individuals who had received a diagnosis of schizophrenia and 189 healthy comparison subjects, individually matched to case subjects on gender and year of birth. Child health cards from the Child Health Archives contain detailed prospective developmental data from birth as well as an indicator of fetal distress, as measured by the Apgar score. Detailed developmental data from the first year of life were extracted. Results: Delayed attainment of milestones in infancy significantly increased the risk of later development of schizophrenia in a dose-response manner. There was no significant main effect of obstetric complications on risk for schizophrenia and no significant association between obstetric complications and subsequent developmental delay. However, the additive effect of obstetric complications and delayed attainment of developmental milestones significantly increased the risk of schizophrenia beyond that associated with each factor independently (odds ratio=4.6, 95% confidence interval=1.3-17.2). Conclusions: These data provide evidence that underlying neurodevelopmental vulnerability, as indexed by delayed attainment of milestones, combined with obstetric adversity significantly increases the risk of schizophrenia in adulthood. [PUBLICATION ABSTRACT] Objective:Obstetric complications and developmental delay are well-established risk factors for schizophrenia. The authors investigated whether these risk factors interact in an additive manner to further increase risk for schizophrenia. Method:The study population encompassed all individuals born in Helsinki between 1962 and 1969 who had developmental records archived in the Helsinki City Archives. Through linkage between the Finnish Population Register, the Finnish Hospital Discharge Register, and the Child Health Archives, child health cards were traced for 189 individuals who had received a diagnosis of schizophrenia and 189 healthy comparison subjects, individually matched to case subjects on gender and year of birth. Child health cards from the Child Health Archives contain detailed prospective developmental data from birth as well as an indicator of fetal distress, as measured by the Apgar score. Detailed developmental data from the first year of life were extracted. Results:Delayed attainment of milestones in infancy significantly increased the risk of later development of schizophrenia in a dose-response manner. There was no significant main effect of obstetric complications on risk for schizophrenia and no significant association between obstetric complications and subsequent developmental delay. However, the additive effect of obstetric complications and delayed attainment of developmental milestones significantly increased the risk of schizophrenia beyond that associated with each factor independently (odds ratio=4.6, 95% confidence interval=1.3–17.2). Conclusions:These data provide evidence that underlying neurodevelopmental vulnerability, as indexed by delayed attainment of milestones, combined with obstetric adversity significantly increases the risk of schizophrenia in adulthood. |
| Author | Clarke, Mary C. Cannon, Mary Leon, David A. Jones, Peter B. Murray, Robin M. Tanskanen, Antti Huttunen, Matti |
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| Keywords | Human Psychosis Motor retardation Follow up study Population-based survey Risk factor Schizophrenia Complication Infant Developmental disorder Obstetrics |
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meta-analytic review publication-title: Am J Psychiatry – volume: 67 start-page: 889 year: 2010 end-page: 894 article-title: Neonatal vitamin D status and risk of schizophrenia: a population-based case-control study publication-title: Arch Gen Psychiatry – volume: 149 start-page: 273 year: 2007 end-page: 277 article-title: Negative association between a history of obstetric complications and the number of neurological soft signs in first-episode schizophrenic disorder publication-title: Psychiatry Res – volume: 71 start-page: 213 year: 2004 end-page: 225 article-title: The persistence of developmental markers in childhood and adolescence and risk for schizophrenic psychoses in adult life: a 34-year follow-up of the Northern Finland 1966 Birth Cohort publication-title: Schizophr Res – volume: 93 start-page: 229 year: 2007 end-page: 236 article-title: The effects of genetic liability for schizophrenia and maternal smoking during pregnancy on obstetric complications publication-title: 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specific to schizophreniform disorder: results from a longitudinal birth cohort publication-title: Arch Gen Psychiatry – volume: 159 start-page: 1514 year: 2002 end-page: 1520 article-title: Contributions of genetic risk and fetal hypoxia to hippocampal volume in patients with schizophrenia or schizoaffective disorder, their unaffected siblings, and healthy unrelated volunteers publication-title: Am J Psychiatry – volume: 40 start-page: 1627 year: 2010 end-page: 1634 article-title: Cannabis use and childhood trauma interact additively to increase the risk of psychotic symptoms in adolescence publication-title: Psychol Med – volume: 97 start-page: 456 year: 1996 end-page: 462 article-title: Can asphyxiated infants at risk for neonatal seizures be rapidly identified by current high-risk markers? publication-title: Pediatrics – volume: 159 start-page: 1514 year: 2002 end-page: 1520 article-title: Contributions of genetic risk and fetal hypoxia to hippocampal volume in patients with 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19 article-title: Early developmental milestones in adult schizophrenia and other psychoses: a 31-year follow-up of the Northern Finland 1966 Birth Cohort publication-title: Schizophr Res – volume: 52 start-page: 1 year: 2001 end-page: 19 article-title: Early developmental milestones in adult schizophrenia and other psychoses: a 31-year follow-up of the Northern Finland 1966 Birth Cohort publication-title: Schizophr Res – volume: 8 start-page: 402 year: 2005 end-page: 408 article-title: Fetal growth restriction and schizophrenia: a Swedish twin study publication-title: Twin Res – volume: 118 start-page: 41 year: 2010 end-page: 47 article-title: Early developmental milestones and risk of schizophrenia: a 45-year follow-up of the Copenhagen Perinatal Cohort publication-title: Schizophr Res – volume: 49 start-page: 221 year: 1992 end-page: 235 article-title: Infants at risk for schizophrenia: sequelae of a genetic neurointegrative defect: a review and replication analysis of 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reference: - Am J Psychiatry. 2011 Dec 1;168(12):1345 |
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| Snippet | Objective:Obstetric complications and developmental delay are well-established risk factors for schizophrenia. The authors investigated whether these risk... Obstetric complications and developmental delay are well-established risk factors for schizophrenia. The authors investigated whether these risk factors... Objective: Obstetric complications and developmental delay are well-established risk factors for schizophrenia. The authors investigated whether these risk... |
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| SubjectTerms | Adult Adult and adolescent clinical studies Biological and medical sciences Case-Control Studies Child development Developmental Disabilities - complications Female Humans Longitudinal Studies Male Medical sciences Middle Aged Motor ability Obstetric Labor Complications Obstetrics Pregnancy Pregnancy Complications Prospective Studies Psychiatry Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Psychoses Risk Risk Factors Schizophrenia Schizophrenia - diagnosis Schizophrenia - etiology |
| Title | Increased Risk of Schizophrenia From Additive Interaction Between Infant Motor Developmental Delay and Obstetric Complications: Evidence From a Population-Based Longitudinal Study |
| URI | http://dx.doi.org/10.1176/appi.ajp.2011.11010011 https://www.ncbi.nlm.nih.gov/pubmed/21890789 https://www.proquest.com/docview/1009828075 https://www.proquest.com/docview/913721318 |
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