Obstetric complications and intelligence in patients on the schizophrenia-bipolar spectrum and healthy participants

Abstract

Background Whether severe obstetric complications (OCs), which harm neural function in offspring, contribute to impaired cognition found in psychiatric disorders is currently unknown. Here, we sought to evaluate how a history of severe OCs is associated with cognitive functioning, indicated by Intelligence Quotient (IQ). Methods We evaluated the associations of a history of OCs and IQ in 622 healthy controls (HC) and 870 patients on the schizophrenia (SCZ) – bipolar disorder (BIP) spectrum from the ongoing Thematically Organized Psychosis study cohort, Oslo, Norway. Participants underwent assessments using the NART (premorbid IQ) and the WASI (current IQ). Information about OCs was obtained from the Medical Birth Registry of Norway. Multiple linear regression models were used for analysis. Results Severe OCs were equally common across groups. SCZ patients with OCs had lower performances on both premorbid and current IQ measures, compared to those without OCs. However, having experienced more than one co-occurring severe OC was associated with lower current IQ in all groups. Conclusions Severe OCs were associated with lower IQ in the SCZ group and in the BIP and HC groups, but only if they had experienced more than one severe OC. Low IQ might be a neurodevelopmental marker for SCZ; wherein, severe OCs influence cognitive abilities and increase the risk of developing SCZ. Considering OCs as a variable of neurodevelopmental risk for severe mental illness may promote the development of neuroprotective interventions, improve outcome in vulnerable newborns and advance our ability to make clinical prognoses.

Association of Birth Asphyxia With Regional White Matter Abnormalities Among Patients With Schizophrenia and Bipolar Disorders

“…Also, inflammatory presentation increases vulnerability, 18 so milder insults may cause injury or alterations in those with a genetic liability for schizophrenia development. 16 Birth asphyxia had a prevalence of 14% in our previous studies, without case-control differences, 17 , 19 , 20 suggesting that the birth asphyxia variable from the MBRN contains a wide range of birth asphyxia exposure.…”

An epigenetic association analysis of childhood trauma in psychosis reveals possible overlap with methylation changes associated with PTSD

“…Participants were enrolled in the study between 2007 and 2018. A further description of the NORMENT sample has been published previously [ 27 ]. For our EWAS, we included 602 patients (no healthy controls).…”

“…All patients were outpatients or stable inpatients from psychiatric units. Previous studies have described patients' exclusion criteria and the clinical assessments of patients [ 27 ]. All patients were assessed with the five-factorial model of the Positive and Negative Syndrome Scale (PANSS) [ 28 ], the Inventory of Depressive Symptomatology (IDS) [ 29 ], and the Global Functioning Scale divided into function (GFS-F) and symptoms (GFS-S) [ 30 ].…”

Schizophrenia: Epidemiology, Causes, Neurobiology, Pathophysiology, and Treatment

“…Severe obstetric complications have been shown to be related to lower IQ and the development of schizophrenia. It is thought that obstetric complications should be considered as a neurodevelopmental risk factor for severe mental illness (Wortinger et al, 2020).…”