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Obstetric complications in children born to parents with schizophrenia: a meta-analysis of case–control studies

Published online by Cambridge University Press:  09 July 2009

A. Sacker*
Affiliation:
Department of Psychiatry, University of Oxford; and Division of Psychology, University of Hertfordshire, Hatfield
D. J. Done
Affiliation:
Department of Psychiatry, University of Oxford; and Division of Psychology, University of Hertfordshire, Hatfield
T. J. Crow
Affiliation:
Department of Psychiatry, University of Oxford; and Division of Psychology, University of Hertfordshire, Hatfield
*
1Address for correspondence: Amanda Sacker, Division of Psychology. University of Hertfordshire, College Lane, Hatfield, Herts. AL10 9AB.

Synopsis

On the basis of previous findings, we used meta-analyses to consider whether births to parents with schizophrenia have an increased risk of obstetric complications. Meta-analyses were based on published studies satisfying the following selection criteria. The schizophrenic diagnosis could apply to either parent: parents with non-schizophrenic psychoses were not included: only normal controls were accepted. In all, 14 studies provided effect sizes or data from which these could be derived. Studies were identified by data searches through MEDLINE, PSYCLIT and through references of papers relating to the subject. Births to individuals with schizophrenia incur an increased risk of pregnancy and birth complications, low birthweight and poor neonatal condition. However, in each case the effect size is small (mean r = 0·155; 95% CI = 0·057). The risk is greater for mothers with schizophrenia and is not confined to mothers with onset pre-delivery or to the births of the children who become schizophrenic themselves.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1996

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References

REFERENCES

Bagedahl-Strindlund, M. (1986). Mentally ill mothers and their children. Acta Psychiatrica Scandinavica 74, 3240.CrossRefGoogle ScholarPubMed
Bolton, P., Macdonald, H., Pickles, A., Rios, P., Goode, S., Crowson, M., Bailey, A. & Rutter, M. (1994). A case-control family history study of autism. Journal of Child Psychology and Psychiatry and Allied Disciplines 35, 877900.CrossRefGoogle ScholarPubMed
Book, J. A., Wetterberg, L. & Modrzewska, K. (1978). Schizophrenia in a North Swedish geographical isolate 1900–1977: epidemiology, genetics and biochemistry. Clinical Genetics 14, 373394.CrossRefGoogle Scholar
Cohen, J. (1977). In Meta-analysis: Quantitative Methods for Research Synthesis by F. M. Wolf. Sage Publications: Beverly Hills. 1986.Google Scholar
Cohler, B. J., Gallant, D. H., Grunebaum, H. U., Weiss, J. L. & Gamer, E. (1975). Pregnancy and birth complications amongst mentally ill and well mothers and their children. Social Biology 22, 269278.CrossRefGoogle Scholar
Cooper, H. (1979). In Meta-analysis: Quantitative Methods for Research Synthesis by F. M. Wolf. Sage Publications: Beverly Hills. 1986.Google Scholar
DeHorn, A. B. & Strauss, M. E. (1977). Birthweights of male and female schizophrenics' offspring. Acta Psychiatrica Scandinavica 55, 321329.CrossRefGoogle ScholarPubMed
Fish, B. (1977). Neurobiological antecedents of schizophrenia in children: evidence for an inherited, congenital neurointegrative defect. Archives of General Psychiatry 34, 12971313.CrossRefGoogle ScholarPubMed
Fish, B., Marcus, J., Hans, S., Auerbach, J. & Perdue, S. (1992). Infants at risk for schizophrenia: sequelae of a genetic neurointegrative defect. A review and replication analysis of pandysmaturation in the Jerusalem Infant Development Study. Archives of General Psychiatry 49, 221235.CrossRefGoogle ScholarPubMed
Garmezy, N. (1974). Children at risk: the search for antecedents of schizophrenia. Part 2. Ongoing research programs, issues and interventions. Schizophrenia Bulletin 9, 55125.CrossRefGoogle Scholar
Geddes, J. R. & Laurie, S. M. (1995). Obstetric complications and schizophrenia: a meta-analysis. British Journal of Psychiatry (in the press).CrossRefGoogle Scholar
Goodman, S. H. (1987). Emory University project on children of disturbed parents. Schizophrenia Bulletin 13, 411423.CrossRefGoogle ScholarPubMed
Goodman, S. H. & Emory, E. K. (1992). Perinatal complications in births to low socioeconomic status schizophrenic and depressed women. Journal of Abnormal Psychology 101, 225229.CrossRefGoogle ScholarPubMed
Gottesman, I. I. (1991). Schizophrenia Genesis: The Origins of Madness. W. H. Freeman & Co.: New York.Google Scholar
Hanson, D. R., Gootesman, I. I. & Heston, L. L. (1976). Some possible childhood indicators of adult schizophrenia inferred from children of schizophrenics. British Journal of Psychiatry 129, 142154.CrossRefGoogle ScholarPubMed
Kety, S. S., Rosenthal, D., Wender, P. H. & Schulsinger, F. (1968). The types and prevalence of mental illness in the biological and adoptive families of adopted schizophrenics. In The Transmission of Schizophrenia (ed. Rosenthal, D. & Kety, S. S.), pp. 345366. Pergamon Press: Oxford.Google Scholar
Lane, E. A. & Albee, G. W. (1970). The birthweight of children born to schizophrenic women. Journal of Psychology 74, 157160.CrossRefGoogle ScholarPubMed
Lewis, S. W. (1989). Congenital risk factors for schizophrenia. Psychological Medicine 19, 513.CrossRefGoogle ScholarPubMed
McNeil, T. F. (1991). Obstetric complications in schizophrenic parents. Schizophrenia Research 5, 89101.CrossRefGoogle ScholarPubMed
McNeil, T. F. & Kaij, L. (1973). Obstetric complicatios and physical size of offspring of schizophrenic, schizophrenic-like and control mothers. British Journal of Psychiatry 123, 341348.CrossRefGoogle Scholar
McNeil, T. F. & Kaij, L. (1978). Obstetric factors in the development of schizophrenia: complications in the births of preschizophrenics and in reproduction by schizophrenic parents. In The Nature of Schizophrenia (ed. Wynne, L. C., Cromwell, R. L. and Matthysse, S.), pp. 401429. Wiley: New York.Google Scholar
McNeil, T. F., Persson-Blennow, I. & Kaij, L. (1974). Reproduction in female psychiatric patients: severity of mental disturbance near reproduction and rates of obstetric complications. Acta Psychiatrica Scandinavica 50, 2332.CrossRefGoogle ScholarPubMed
Marcus, J., Auerbach, J., Wilkinson, L. & Burack, C. M. (1981). Infants at risk for schizophrenia: the Jerusalem Infant Development Study. Archives of General Psychiatry 38, 703713.CrossRefGoogle ScholarPubMed
Mednick, S. A., Mura, E., Schulsinger, F. & Mednick, B. (1971). Perinatal conditions and infant development in children with schizophrenic parents. Social Biology 18, 103113.Google ScholarPubMed
Mednick, S. A., Mura, E., Schulsinger, F. & Mednick, B. (1973). Erratum and further analysis. Perinatal complications and infant development in children with schizophrenic parents. Social Biology 20, 111112.CrossRefGoogle Scholar
Mirdal, M. G. K., Mednick, S. A., Schulsinger, F. & Fuchs, F. (1974). Perinatal complications in children of schizophrenic mothers. Acta Psychiatrica Scandinavica 50, 553568.CrossRefGoogle ScholarPubMed
Modrzewska, K. (1980). The offspring of schizophrenic parents in a North Swedish isolate. Clinical Genetics 17, 191201.CrossRefGoogle Scholar
Mosteller, F. & Bush, R. R. (1954). In Meta-analysis: Quantitative Methods for Research Synthesis by F. M. Wolf. Sage Publications: Beverly Hills. 1986.Google Scholar
Oxman, A., Chalmers, I., Clarke, M., Endkin, M., Schulz, K. & Starr, M. (eds.) (1994). The Cochrane Collaboration Tookkit Section VI: Preparing and Maintaining Systematic Reviews. The Cochrane Collaboration: Oxford.Google Scholar
Paffenbarger, R. S., Steinmetz, C. H., Pooler, B. G. & Hyde, R. T. (1961). The picture puzzle of the postpartum psychoses. Journal of Chronic Diseases 13, 161173.CrossRefGoogle ScholarPubMed
Parnas, J., Schulsinger, F., Teasdale, T. W., Schulsinger, H.,Feldman, P. M. & Mednick, S. A. (1982). Perinatal complications and clinical outcome within the schizophrenia spectrum. British Journal of Psychiatry 140, 416420.CrossRefGoogle ScholarPubMed
Ragins, N., Schachte, J., Elmer, E., Preisman, R., Bowes, A. E. & Harway, V. (1975). Infants and children at risk for schizophrenia. Journal of American Academy of Child Psychiatry 14, 150177.CrossRefGoogle ScholarPubMed
Rieder, R. O., Rosenthal, D.,Wender, P. & Blumenthal, H. (1975). The offspring of schizophrenics: fetal and neonatal deaths. Archives of General Psychiatry 32, 200211.CrossRefGoogle ScholarPubMed
Rieder, R. O., Broman, S. H. & Rosenthal, D. (1977). The offspring of schizophrenics. II. Perinatal factors and IQ. Archives of General Psychiatry 34, 789799.CrossRefGoogle ScholarPubMed
Sacker, A., Done, D. J., Crow, T. J. & Golding, J. (1995). Antecedents of schizophrenia and effective disorder: obstetric complications. British Journal of Psychiatry 166, 734741.CrossRefGoogle ScholarPubMed
Sameroff, A. J. & Zax, M. (1973). Perinatal characteristics of the offspring of schizophrenic women. Journal of Nervous and Mental Disease 157, 191201.CrossRefGoogle ScholarPubMed
Sameroff, A. J., Seifer, R., Zax, M. & Barocas, R. (1987). Early indicators of developmental risk: Rochester Longitudinal Study. Schizophrenia Bulletin 13, 383394.CrossRefGoogle ScholarPubMed
Schachter, J., Kerr, J., Lachin, J. M. & Faer, M. (1975). Newborn offspring of a schizophrenic parent: Cardiac reactivity to auditory stimuli. Psychophysiology 12, 483491.CrossRefGoogle ScholarPubMed
Schachter, J., Lachin, J., Spruill, L., Johan, M., Saladin, L. & Williams, T. A. (1995). Maternal psychopathology and complications of pregnancy and delivery. (Unpublished manuscript).Google Scholar
Silverton, L., Finello, K. & Mednick, S. (1983). Children of schizophrenic women: early factors predictive of schizophrenia. Infant Mental Health Journal 4, 202216.3.0.CO;2-3>CrossRefGoogle Scholar
Silverton, L., Finello, K. M., Mednick, S. A. & Schulsinger, F. (1985). Low birthweight and ventricular enlargement in a high-risk sample. Journal of Abnormal Psychology 94, 405409.CrossRefGoogle Scholar
Sobel, D. E. (1961). Infant mortality and malformations in children of schizophrenic women. Psychiatric Quarterly 35, 6064.CrossRefGoogle Scholar
Soichet, S. (1959). Emotional factors in toxemia of pregnancy. American Journal of Obstetric Gynecology 77, 1065.CrossRefGoogle ScholarPubMed
Spielvogel, A. & Wile, J. (1992). Treatment and outcomes of psychotic patients during pregnancy and childbirth. Birth 19, 131137.CrossRefGoogle ScholarPubMed
Walker, E. & Emory, E. (1983). Infants at risk for psychopathology: offspring of schizophrenic parents. Child Development 54, 12691285.CrossRefGoogle ScholarPubMed
Wiedorn, W. S. (1954). Toxaemia of pregnancy and schizophrenia. Journal of Nervous and Mental Disease 120, 19.CrossRefGoogle ScholarPubMed
Wolf, F. M. (1986). Meta-analysis: Quantiative Methods for Research Synthesis. Sage Publications: Beverly Hills.CrossRefGoogle Scholar
Wrede, G., Mednick, S. A., Huttunen, M. O. & Nilsson, C. G. (1980). Pregnancy and delivery complications in the births of an unselected series of Finnish children with schizophrenic mothers. Acta Psychiatrica Scandinavica 62, 369381.CrossRefGoogle ScholarPubMed
Yarden, P. E. & Suranyi, I. (1968). The early development of institutionalized children of schizophrenic mothers. Diseases of the Nervous System 29, 380391.Google ScholarPubMed
Zax, M., Sameroff, A. J. & Babigian, H. M. (1977). Birth outcomes in the offspring of mentally disordered women. American Journal of Orthopsychiatry 47, 218230.CrossRefGoogle ScholarPubMed