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1.
Most investigations that report a positive association between obstetric complications and schizophrenia have been case-control studies that are often based on long-term maternal recall of events during pregnancy. We tested the hypothesis that mothers of adult offspring with schizophrenia or other psychoses systematically overreport obstetric complications compared with mothers of unaffected offspring. Subjects were selected from the New England cohorts of the National Collaborative Perinatal Project, a large prospective cohort with well-documented records of pregnancy and delivery. Mothers of 39 offspring with psychosis and 39 control offspring were recontacted and completed a structured interview regarding their pregnancy history. Accuracy of maternal recall varied greatly in relation to the type of pregnancy event, and recall was inaccurate for many specific events. For the control sample only, maternal recall of the total number of complications corresponded closely to chart information. Contrary to the study hypothesis, mothers of offspring with psychosis report fewer complications than indicated in their obstetric records, with no evidence of positive recall bias. These results suggest that previous reports of a positive association between obstetric complications and schizophrenia are not likely to have resulted from biased maternal recall.  相似文献   

2.
OBJECTIVE: We sought to explore whether obstetric complications (OCs) are more likely to occur in the presence of familial/genetic susceptibility for schizophrenia or whether they themselves represent an independent environmental risk factor for schizophrenia. METHODS: The presence of OCs was assessed through maternal interview on 216 subjects, comprising 36 patients with schizophrenia from multiply affected families, 38 of their unaffected siblings, 31 schizophrenic patients with no family history of psychosis, 51 of their unaffected siblings and 60 normal comparison subjects. We examined the familiality of OCs and whether OCs were commoner in the patient and sibling groups than in the control group. RESULTS: OCs tended to cluster within families, especially in multiply affected families. Patients with schizophrenia, especially those from multiply affected families, had a significantly higher rate of OCs compared to normal comparison subjects, but there was no evidence for an elevated rate of OCs in unaffected siblings. CONCLUSION: Our data provides little evidence for a link between OCs and genetic susceptibility to schizophrenia. If high rates of OCs are related to schizophrenia genes, this relationship is weak and will only be detected by very large sample sizes.  相似文献   

3.
The purpose of this study was to determine whether a genetic vulnerability for schizophrenia and/or health-risk behaviors among schizophrenic pregnant women were associated with an increased incidence of obstetric complications (OCs). METHOD: A high-risk birth cohort was formed by searching the Finnish Perinatal Register for all births from 1991-2000 with arterial cord pH values below 7.20, an indication of fetal asphyxia. This database was merged with national hospital discharge registries to determine psychiatric morbidity of the mothers and the mothers' first-degree relatives. Mothers were divided into 3 groups: women diagnosed with schizophrenia/schizoaffective disorder (n=53), mothers with a first-degree relative with schizophrenia/schizoaffective disorder (n=590) and healthy controls (n=36,895). RESULT: Schizophrenic women had significantly more OCs than mothers with a first-degree schizophrenic relative and controls. These women had significantly increased rates of eclampsia, premature delivery, prenatal hospitalizations, and marginally significant increases in high blood pressure. Offspring of schizophrenic mothers had significantly decreased APGAR scores and birth weight and increased medical complications after birth. In contrast, women with a schizophrenic first-degree relative had no significant increases in OCs compared to controls. Schizophrenic mothers also smoked more than the other groups and smoking was found to mediate the relationship between maternal schizophrenic status and decreased birth weight among offspring. CONCLUSIONS: Maternal schizophrenia during pregnancy leads to an increased risk of OCs, possibly due to engagement in health-risk behaviors during pregnancy, such as smoking, whereas genetic susceptibility to schizophrenia, by itself, does not appear to be related to incidence of OCs.  相似文献   

4.
Neurodevelopmental schizophrenia seems to be caused by impaired cerebral development and is supposed to be associated with obstetric complications (OCs), poor premorbid adjustment, schizotypal or schizoid personality traits and negative symptoms. In the present study, 36 schizophrenic and schizoaffective patients and their same-sex, healthy siblings were recruited. They were diagnosed according to DSM-III-R, using structured psychiatric interviews and a consensus of 2 psychiatrists. Information on OCs, birth weight, premorbid social and learning functioning was obtained from their mothers. The main results show significant differences in OCs, birth weight, premorbid social and learning functioning between patients and their same-sex, healthy siblings. Using multivariate analyses, both premorbid variables were again identified to discriminate well between affected and unaffected siblings. Our findings seem to confirm the concept of schizophrenia as a neurodevelopmental process.  相似文献   

5.
Previous studies have indicated that obstetric complications (OCs) may be risk factors for schizophrenia, but findings are inconsistent, and data about other diagnostic groups are relatively scarce. We compared the obstetric histories of subjects with schizophrenia, major affective disorder and normal controls. Our subjects included 61 schizophrenia, 26 schizoaffective, 28 major affective disorder patients and 21 normal controls. OCs were rated on the McNeil–Sjöström Scale using data from mothers reports and for a subsample from hospital and birth certificate records. The frequency of OCs did not differ statistically between diagnostic groups at any stage or for the three stages combined. OCs of at least level 4 were found in 69% of schizophrenia patients, 62% of schizoaffective patients, 68% of major affective disorder patients and 71% of the normal comparison group. OCs of at least level 5 were found in 23% of schizophrenia patients, 23% of schizoaffective patients, 21% of the major affective disorder patients and 14% of the normal comparison group. Our findings indicate that the etiologic significance of OCs may not be specific to schizophrenia.  相似文献   

6.
OBJECTIVE: In this birth cohort study, the authors examined the relation between prenatal exposure to maternal genital/reproductive (G/R) infections and schizophrenia in offspring. METHOD: The birth cohort consisted of 7,794 offspring of pregnancies with prospectively acquired data on maternal G/R infections from obstetric records. The authors diagnosed 71 cases of schizophrenia and other schizophrenia spectrum disorders in this cohort. The relationship between maternal G/R infections and schizophrenia risk was modeled. RESULTS: Exposure to G/R infections during the periconceptional period was associated with a significantly increased risk of schizophrenia and other schizophrenia spectrum disorders, with adjustment for maternal race, education, age, and mental illness. CONCLUSIONS: Maternal G/R infection during periconception appears to increase the risk of schizophrenia in offspring.  相似文献   

7.
Low birth weight (LBW) and hypoxia are among the environmental factors most reliably associated with schizophrenia; however, the nature of this relationship is unclear and both gene-environment interaction and gene-environment covariation models have been proposed as explanations. High-risk (HR) designs that explore whether obstetric complications differentially predict outcomes in offspring at low risk (LR) vs HR for schizophrenia, while accounting for differences in rates of maternal risk factors, may shed light on this question. This study used prospectively obtained data to examine relationships between LBW and hypoxia on school outcome at age 15–16 years in a Finnish sample of 1070 offspring at LR for schizophrenia and 373 offspring at HR for schizophrenia, based on parental psychiatric history. Controlling for offspring sex, maternal smoking, social support, parity, age, and number of prenatal care visits, HR offspring performed worse than LR offspring across academic, nonacademic, and physical education domains. LBW predicted poorer academic and physical education performance in HR offspring, but not in LR offspring, and this association was similar for offspring of fathers vs mothers with schizophrenia. Hypoxia predicted poorer physical education score across risk groups. Rates of LBW and hypoxia were similar for LR and HR offspring and for offspring of fathers vs mothers with schizophrenia. Results support the hypothesis that genetic susceptibility to schizophrenia confers augmented vulnerability of the developing brain to the effects of obstetric complications, possibly via epigenetic mechanisms.Key words: low birth weight, hypoxia, high risk, academic, physical education  相似文献   

8.
OBJECTIVE: We investigated whether antenatal factors in mothers would increase the risk of schizophrenia in the offspring, and also examined any relationship between these factors and histories of obstetric complications (OCs). METHOD: Using the Mother and Child Health Handbooks of 52 patients with schizophrenia and 284 healthy subjects, we evaluated the risk-increasing effects of the frequency of antenatal care visits and mothers' body mass index (BMI) at both early and late pregnancy. RESULTS: In logistic regression analysis, there was a significant association between the number of antenatal care visits and the risk of the disorder; an increase in a unit of visits corresponds to a reduction of the risk by 12%. We also found a 24% increase in the risk with a one-unit increase of BMI at the early pregnancy, and a 19% increase at the late pregnancy. These antenatal factors were found to contribute, in part, to an excess of OCs in individuals with schizophrenia. CONCLUSION: Poor maternal care during pregnancy and comparatively high maternal BMI especially at early pregnancy may cause a predisposition to schizophrenia in the offspring.  相似文献   

9.
Adverse obstetric events have been implicated as risk factors for schizophrenia. Many studies have relied on retrospective recall of these events, given typical adult onset of schizophrenia, when most studies ascertain their samples. The goal of this study was to assess the validity of an interview for the long-term recall of prenatal and perinatal events. Ninety-six women from the Providence and Boston cohorts of the National Collaborative Perinatal Project were administered a brief structured telephone interview regarding their recall of pregnancy-related events that had occurred 22 years or more prior to interview. Women accurately reported major medical events such as cesarean section, breech delivery, and multiple birth (kappa=1) and demographic items, such as age at birth and parity. Medical interventions and major medical conditions such as placental (kappa=-0.01) and cord (kappa=-0.10) difficulties were not accurately reported. Estimated birthweight, low birthweight, and length of gestation were recalled with reasonable accuracy. Women who completed high school generally recalled events more accurately than those who did not. It is therefore important to attend to the sources of information, the mode of interviewing, the specific type of event, and sociodemographic characteristics of the informant to improve the accuracy of retrospective data on obstetric events, and to increase the validity of findings relating these to the onset of schizophrenia.  相似文献   

10.
A large body of research suggests a relationship between maternal influenza and the development of schizophrenia in the adult offspring. Some researchers, however, have questioned this association. A study by Crow and Done (1992) asserts that prenatal exposure to influenza does not cause schizophrenia. The methodology employed by Crow and Done may account for their null findings. Crow and colleagues assessed influenza by asking mothers at the time of birth to recall influenza infections experienced during pregnancy. Such retrospective recall may bias reporting. We assessed influenza symptoms during pregnancy in a group of 136 mothers at the twenty-fifth week of pregnancy, and again one or two days after birth. We compared accounts of influenza at the twenty-fifth week to recollection of influenza after birth. Results suggest that mothers tend to under-report infections when recalling infections after birth. Retrospective assessment of influenza symptoms at birth may be an inaccurate method of assessing influenza during pregnancy.  相似文献   

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