Skip to main content Accessibility help

Obstetric complications in patients with schizophrenia and their unaffected siblings

  • M. Walshe (a1), C. McDonald (a1), M. Taylor (a1), J. Zhao (a1), P. Sham (a1), A. Grech (a1), K. Schulze (a1), E. Bramon (a1) and R.M. Murray (a1)...



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.


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.


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.


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.


Corresponding author

*Corresponding author. E-mail address: (C. McDonald).


Hide All
[1]American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders. Washington: American Psychiatric Press; 1987. (DC)
[2]Bennesden, BAdverse pregnancy outcome in schizophrenic women: occurrence of risk factors. Schizophr Res 1998;22:126.
[3]Blondel, B, Dutilh, P, Delour, M, Uzan, SPoor antenatal care and pregnancy outcome. Eur J Obstet Gynecol Reprod Biol 1993;50:191196.10.1016/0028-2243(93)90200-V
[4]Buka, SL, Goldstein, JM, Seidman, LJ, Tsuang, MTMaternal recall of pregnancy history: accuracy and bias in schizophrenia research. Schizophr Bull 2000;26:335350.
[5]Cannon, M, Jones, PB, Murray, RMObstetric complications and schizophrenia: historical and meta-analytic review. Am J Psychiat 2002;159:10801092.
[6]Cannon, TD, Rosso, IM, Hollister, JM, Bearden, CE, Sanchez, LE, Hadley, TA prospective cohort study of genetic and perinatal influences in the etiology of schizophrenia. Schizophr Bull 2000;26:351366.
[7]Cannon, TD, Van Erp, TGM, Rosso, IM, Huttunen, M, Lonnqvist, J, Pirkola, Tet al.Fetal hypoxia and structural brain abnormalities in schizophrenic patients, their siblings, and controls. Arch Gen Psychiatr 2002;59:3541.
[8]Cantor-Graae, E, Ismail, B, McNeil, TFAre neurological abnormalities in schizophrenic patients and their siblings the result of perinatal trauma?. Acta Psychiatr Scand 2000;101:142147.
[9]Cantor-Graae, E, Cardenal, S, Ismail, B, McNeil, TFRecall of obstetric events by mothers of schizophrenic patients. Psychol Med 1998;28:12391243.10.1017/S0033291798006953
[10]Crawford, TJ, Sharma, T, Puri, BK, Murray, RM, Berridge, DM, Lewis, SWSaccadic eye movements in families multiply affected with schizophrenia: the Maudsley Family Study. Am J Psychiat 1998;155:17031710.
[11]DeLisi, LE, Goldin, LR, Maxwell, EM, Kazuba, DM, Gershon, ESClinical features of illness in siblings with schizophrenia or schizoaffective disorder. Arch Gen Psychiatr 1987;44:891896.
[12]Eagles, JM, Gibson, I, Bremner, MH, Clunie, F, Ebmeier, KP, Smith, NCObstetric complications in DSM-III schizophrenics and their siblings. Lance 1990;335:11391141.
[13]Endicott, J, Andreasen, NC, Spitzer, RLFamily history research diagnostic criteri. New York: New York State Psychiatric Institute, Biometrics Research Division; 1975.
[14]Faraone, SV, Seidman, LJ, Kremen, WS, Toomey, R, Pepple, JR, Tsuang, MTNeuropsychologic functioning among the nonpsychotic relatives of schizophrenic patients: the effect of genetic loading. Biol Psychiatr 2000;48:120126.
[15]Filippi, V, Ronsmans, C, Gandaho, T, Graham, W, Alihonou, E, Santos, PWomen’s reports of severe (near-miss) obstetric complications in Benin. Stud Fam Plann 2000;31:309324.
[16]Frangou, S, Sharma, T, Sigmudsson, T, Barta, Pet al.The Maudsley Family Study 4: normal planum temporale asymmetry in familial schizophrenia: a volumetric MRI study. Br J Psychiatr 1997;170:328333.10.1192/bjp.170.4.328
[17]Franzek, E, Stober, GMaternal infectious diseases during pregnancy and obstetric complications in the etiology of distinct subtypes of schizophrenia: further evidence from maternal hospital records. Eur Psychiatr 1995;10:326330.
[18]Geddes, JR, Lawrie, SMObstetric complications and schizophrenia: a meta-analysis. Br J Psychiatr 1995;167:786793.
[19]Griffiths, TD, Sigmundsson, T, Takei, N, Rowe, D, Murray, RMNeurological abnormalities in familial and sporadic schizophrenia. Brai 1998;121:191203.
[20]Gunther-Genta, F, Bovet, P, Hohlfeld, PObstetric complications and schizophrenia. A case–control study. Br J Psychiatr 1994;164:165170.
[21]H.M.S.O Office of population censuses and surveys, standard occupational classification. London: HMSO; 1991.
[22]Heun, R, Maier, WThe role of obstetric complications in schizophrenia. J Nerv Ment Dis 1993;181:220226.
[23]Howard, LM, Goss, C, Leese, M, Thornicroft, GMedical outcome of pregnancy in women with psychotic disorders and their infants in the first year after birth. Br J Psychiatr 2003;182:6367.
[24]Kinney, DK, Levy, DL, Yurgelun-Todd, DA, Medoff, D, LaJonchere, CM, Radford-Paregol, MSeason of birth and obstetrical complications in schizophrenics. J Psychiatr Res 1994;28:499509.
[25]Lewis, SW, Owen, MJ, Murray, RMObstetric complications and schizophrenia: methodology and mechanisms. Schulz, SC, Tamminga, CASchizophrenia: scientific progres. New York (NY) US: Oxford University Press; 1989. 5668.
[26]Liu, S, Shi Wu, W, Demissie, K, Marcoux, S, Kramer, MSMaternal asthma and pregnancy outcomes: a retrospective cohort study. Am J .Obstet Gynecol 2001;184:9096.
[27]Loffredo, CA, Wilson, PD, Ferencz, CMaternal diabetes: an independent risk factor for major cardiovascular malformations with increased mortality of affected infants. Teratolog 2001;64:98106.
[28]Marcelis, M, Van Os, J, Sham, P, Jones, P, Gilvarry, C, Cannon, Met al.Obstetric complications and familial morbid risk of psychiatric disorders. Am J Med Genet 1998;81:2936.
[29]McDonald, C, Grech, A, Toulopoulou, T, Schulze, K, Chapple, B, Sham, Pet al.Brain volumes in familial and non-familial schizophrenic probands and their unaffected relatives. Am J Med Genet 2002;114:616625.
[30]McIntosh, AM, Holmes, S, Gleeson, S, Burns, JK, Hodges, AK, Byrne, MMet al.Maternal recall bias, obstetric history and schizophrenia. Br J Psychiatr 2002;181:520525.
[31]Moldin, SO, Gottesman, IIGenes, experience, and chance in schizophrenia–positioning for the 21st century. Schizophr Bull 1997;23:547561.
[32]Mostello, D, Catlin, TK, Roman, L, Holcomb, WL, Leet, TPreeclampsia in the parous woman: who is at risk?. Am J Obstet Gynecol 2002;187:425429.
[33]Nelson, K, JH, EAntecedents of cerebral palsy. Multivariate analysis of risk. N Engl J Med 1986;315:8186.
[34]Nilsson, E, Lichtenstein, P, Cnattingius, S, Murray, RM, Hultman, CMWomen with schizophrenia: pregnancy outcome and infant death among their offspring. Schizophr Res 2002;58:221229.
[35]Nurnberger, JI, Blehar, MC, Kaufmann, CA, York-Cooler, C, Simpson, SG, Harkavy-Friedman, Jet al.Diagnostic interview for genetic studies. Rationale, unique features, and training. NIMH Genetics Initiative. Arch Gen Psychiatr 1994;51:849859.
[36]O’Callaghan, E, Gibson, T, Colohan, HA, Buckley, P, Walshe, DG, Larkin, Cet al.Risk of schizophrenia in adults born after obstetric complications and their association with early onset of illness–a controlled-study. BM 1992;305:12561259.10.1136/bmj.305.6864.1256
[37]O’Callaghan, E, Larkin, C, Kinsella, A, Waddington, JLObstetric complications, the putative familial-sporadic distinction, and tardive dyskinesia in schizophrenia. Br J Psychiatr 1990;157:578584.
[38]O’Callaghan, E, Larkin, C, Waddington, JLObstetric complications in schizophrenia and the validity of maternal recall. Obstetric complications in schizophrenia and the validity of maternal recall. Psychol Me 1990;20:8994.
[39]Peacock, JL, Bland, JM, Anderson, HRPreterm delivery: effects of socioeconomic factors, psychological stress, smoking, alcohol, and caffeine. BM 1995;311:531535.
[40]Rosso, IM, Cannon, TD, Huttunen, T, Huttunen, MO, Lonnqvist, J, Gasperoni, TLObstetric risk factors for early-onset schizophrenia in a Finnish birth cohort. Am J Psychiat 2000;157:801807.
[41]Roy, M, Crowe, RValidity of the familial and sporadic subtypes of schizophrenia. Am J Psychiat 1994;151:805814.
[42]Sacker, A, Done, D, Crow, TObstetric complications in children born to parents with schizophrenia: a meta-analysis of case-control studies. Psychol Med 1996;26:279287.
[43]Seidman, LJ, Faraone, SV, Goldstein, JM, Kremen, WS, Horton, NJ, Makris, Net al.Left hippocampal volume as a vulnerability indicator for schizophrenia: A magnetic resonance imaging morphometric study of nonpsychotic first-degree relatives. Arch Gen Psychiatr 2002;59:839849.
[44]Sham, PC, Jones, P, Russell, A, Gilvarry, K, Bebbington, P, Lewis, Set al.Age at onset, sex, and familial psychiatric morbidity in schizophrenia–Camberwell collaborative psychosis study. Br J Psychiatr 1994;165:466473.
[45]Spitzer, R, Endicott, JSchedule for affective disorders and schizophrenia—lifetime versio New York: New York State Psychiatric Institute; 1978.
[46]Tsuang, MT, Stone, WS, Faraone, SVGenes, environment and schizophrenia. Br J Psychiatr 178Suppl. 402001 s18s24.
[47]Verdoux, H, Geddes, JR, Takei, N, Lawrie, SM, Bovet, P, Eagles, JMet al.Obstetric complications and age at onset in schizophrenia: an international collaborative meta-analysis of individual patient data. Am J Psychiat 1997;154:12201227.
[48]Woerner, MG, Pollack, M, Klein, DFPregnancy and birth complications in psychiatric patients: a comparison of schizophrenic and personality disorder patients with their siblings. Acta Psychiatr Scand 1973;49:712721.
[49]Yawn, BP, Suman, VJ, Jacobsen, SJMaternal recall of distant pregnancy events. J Clin Epidemiol 1998;51:399405.


Obstetric complications in patients with schizophrenia and their unaffected siblings

  • M. Walshe (a1), C. McDonald (a1), M. Taylor (a1), J. Zhao (a1), P. Sham (a1), A. Grech (a1), K. Schulze (a1), E. Bramon (a1) and R.M. Murray (a1)...


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.

Obstetric complications in patients with schizophrenia and their unaffected siblings

  • M. Walshe (a1), C. McDonald (a1), M. Taylor (a1), J. Zhao (a1), P. Sham (a1), A. Grech (a1), K. Schulze (a1), E. Bramon (a1) and R.M. Murray (a1)...
Submit a response


No Comments have been published for this article.


Reply to: Submit a response

Your details

Conflicting interests

Do you have any conflicting interests? *