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Degree of fetal growth restriction associated with schizophrenia risk in a national cohort

Published online by Cambridge University Press:  09 January 2013

M. G. Eide ,
D. Moster ,
L. M. Irgens ,
T. Reichborn-Kjennerud ,
C. Stoltenberg ,
R. Skjærven ,
E. Susser  and
K. Abel
M. G. Eide*
Affiliation:
Norwegian Institute of Public Health, Bergen, Norway Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
D. Moster
Affiliation:
Locus of Registry-Based Epidemiology, Department of Public Health and Primary Health Care, University of Bergen, Norway Department of Pediatrics, Haukeland University Hospital, Bergen, Norway
L. M. Irgens
Affiliation:
Locus of Registry-Based Epidemiology, Department of Public Health and Primary Health Care, University of Bergen, Norway The Medical Birth Registry of Norway, Norwegian Institute of Public Health, Norway
T. Reichborn-Kjennerud
Affiliation:
Division of Mental Health, Norwegian Institute of Public Health, Norway Institute of Psychiatry, University of Oslo, Norway
C. Stoltenberg
Affiliation:
Norwegian Institute of Public Health, Bergen, Norway
R. Skjærven
Affiliation:
Locus of Registry-Based Epidemiology, Department of Public Health and Primary Health Care, University of Bergen, Norway The Medical Birth Registry of Norway, Norwegian Institute of Public Health, Norway
E. Susser
Affiliation:
Mailman School of Public Health and New York State Psychiatric Institute, Columbia University, New York, NY, USA
K. Abel
Affiliation:
Centre for Women's Mental Health, Community-Based Medicine, University of Manchester, UK
*
*Address for correspondence: Dr M. G. Eide, Department of Obstetrics and Gynecology, Haukeland University Hospital, N-5021 Bergen, Norway. (Email: martha.eide@mfr.uib.no)
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Abstract

Background

Accumulating evidence suggests that fetal growth restriction may increase risk of later schizophrenia but this issue has not been addressed directly in previous studies. We examined whether the degree of fetal growth restriction was linearly related to risk of schizophrenia, and also whether maternal pre-eclampsia, associated with both placental dysfunction and poor fetal growth, was related to risk of schizophrenia.

Method

A population-based cohort of single live births in the Medical Birth Registry of Norway (MBRN) between 1967 and 1982 was followed to adulthood (n = 873 612). The outcome was schizophrenia (n=2207) registered in the National Insurance Scheme (NIS). The degree of growth restriction was assessed by computing sex-specific z scores (standard deviation units) of ‘birth weight for gestational age’ and ‘birth length for gestational age’. Analyses were adjusted for potential confounders. Maternal pre-eclampsia was recorded in the Medical Birth Registry by midwives or obstetricians using strictly defined criteria.

Results

The odds ratio (OR) for schizophrenia increased linearly with decreasing birth weight for gestational age z scores (p value for trend = 0.005). Compared with the reference group (z scores 0.01–1.00), the adjusted OR [95% confidence interval (CI)] for the lowest z-score category (< − 3.00) was 2.0 (95% CI 1.2–3.5). A similar pattern was observed for birth length for gestational age z scores. Forty-nine individuals with schizophrenia were identified among 15 622 births with pre-eclampsia. The adjusted OR for schizophrenia following maternal pre-eclampsia was 1.3 (95% CI 1.0–1.8).

Conclusions

Associations of schizophrenia risk with degree of fetal growth restriction and pre-eclampsia suggest future research into schizophrenia etiology focusing on mechanisms that influence fetal growth, including placental function.

Keywords

Birth lengthbirth weightfetal growthpre-eclampsiapopulation studyschizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 10 , October 2013 , pp. 2057 - 2066
Copyright
Copyright © Cambridge University Press 2013 

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