Birth Weight and Obstetric Complications Determine Age at Onset in First Episode of Psychosis

Abstract

Introduction. Genetic and environmental factors involving familial antecedents and prenatal development have been described to increase risk of schizophrenia and to bring forward age at onset. Objectives. To evaluate the relationship between age at onset of psychosis (AOP) and parents age and antecedents, OCs and weight and gestational age at birth in patients with a first episode of psychosis. Method. 90 patients with first-episode psychosis were included. Socio-demographic characteristics, clinical variables and drug use were assessed through a questionnaire using the Structured Clinical Interview for DSM (SCID). Family history of psychosis was assessed through the Andreasen interview and OCs were measured using the Lewis and Murray Obstetric Complication Scale. Also age of parents at patient's birth, miscarriages previous to patient's birth, mother's use of drugs during pregnancy and weight and gestational age at birth were investigated. Results. An earlier AOP was significantly related to earlier use of stimulating drugs (p 0.044), paternal antecedent of psychosis (p 0.044), pre-eclampsia (p 0.000), use of forceps (p 0.001) and need of incubator at birth (p 0.000). Also birth weight was positively related to AOP (r 0.297, p 0.015). Other significant relationship of AOP with obstetric and family variables or drug use were not found. Conclusions. These findings are consistent with previous studies results which had found association between OCs and low birth weight and AOP. Previous and current results underline the role of the prenatal period in the development of schizophrenia and the importance of careful monitoring of pregnancies of mothers with psychotic disorder.

Impact of Polygenic Risk for Schizophrenia on Cortical Structure in UK Biobank

“…Another important consideration, as per neurodevelopmental theories of the disorder (7-9), relates to potential effects of other risk factors for schizophrenia and their interactions between schizophrenia liability and cortical structure. Several obstetric complications (OCs), for example, have been consistently identified as risk factors for schizophrenia (56)(57)(58)(59)(60)(61)(62)(63) with some, such as birth weight, considered to be influenced by both genetic and environmental components (64). Previous studies have also suggested that OCs are associated with greater cortical structure deficits in schizophrenia patients compared to controls (27,63).…”

Obstetric complications in women with schizophrenia

“…The use of forceps and birth weight are variables that best predict AOP in the first episode of psychosis (FEP). Stimulants, which were most commonly used together with marijuana and cocaine, were the only substances associated with the earlier AOP [90].…”

“…Przy czym używanie kleszczy i masa urodzeniowa są zmiennymi, które najlepiej przewidują AOP w pierwszym epizodzie psychozy (first episode of psychosis -FEP). Leki pobudzające, które były najczęściej stosowane razem z marihuaną i kokainą, były jedynymi substancjami związanymi z wcześniejszym AOP [90]…”

Organization framework and preliminary findings from the Athens First‐Episode Psychosis Research Study

“…Epidemiological studies have demonstrated the association of certain environmentally mediated risks with psychosis. These risk factors include urbanicity (Richardson, Hameed, Perez, Jones, & Kirkbride, ), cannabis use (Schoeler et al, ; Setién‐Suero et al, ), immigration (Kirkbride et al, ), obstetric or perinatal complications (Rubio‐Abadal et al, ), psychosocial stress (Dimitrakopoulos et al, ), childhood adversities or abuse and others (Bifulco, Bernazzani, Moran, & Jacobs, ; Stilo et al, ; Trotta et al, ). However, there is great variability in individuals regarding the reverberations of environmental exposures, hence in the field of psychosis biopsychosocial interaction seems to work in a complex way (European Network of National Networks studying Gene‐Environment Interactions in Schizophrenia, ; Van Os, Rutten, & Poulton, ).…”