Obstetrical complications and subsequent schizophrenia in adolescent and young adult offsprings: is there a relationship?

被引:46
作者
Boog, G [1 ]
机构
[1] Dept Obstet & Gynecol, F-44093 Nantes 1, France
关键词
obstetrical complications; schizophrenia; hormonal supplementation; prenatal stress; maternal denutrition; viral exposition;
D O I
10.1016/j.ejogrb.2003.09.041
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Schizophrenia is a psychiatric disease affecting around 1% of the population, the negative signs of which are correlated with inactivity of the prefrontal dorsolateral cortex, while an increased, more deeply localized, activity in the mesolimbic pathway may explain the positive signs. Several events occurring during pregnancy are likely to be involved in its genesis: hormonal supplementation by diethylstilbestrol, severe maternal denutrition, exposure to influenza virus, repeated psychological stress. From multicentric studies and meta-analyses in the psychiatric literature, the risk of schizophrenia appears to be multiplied by two if pregnancy is complicated, mainly by diabetes, Rhesus incompatibility, bleeding, preeclampsia, premature rupture of membranes and preterm birth. When delivery is linked to an abnormal presentation or happens via a caesarean birth for acute foetal distress, the time when the first signs of psychosis appear seems to be earlier in adolescence or in early adulthood. Cerebral imaging of schizophrenic patients shows ventriculomegaly and gray matter reduction, mainly in hippocampal volumes and in the dorsolateral prefrontal cortex. Similar alterations in the neuronal pathways have been experimentally reproduced in rats after repeated prenatal stress and perinatal hypoxia. A region on the distal portion of chromosome I has shown evidence for linkage to schizophrenia. Therefore, a two factor model seems to be able to explain the onset of schizophrenia in which obstetrical complications may interact with a genetic liability and in which the consequences of hypoxic events may lie on a continuum ranging from cerebral palsy in some children to subtle cognitive and behavioural disturbances in others. (C) 2003 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:130 / 136
页数:7
相关论文
共 82 条
[31]   PSYCHOSIS AND PRENATAL EXPOSURE TO DIETHYLSTILBESTROL [J].
KATZ, DL ;
FRANKENBURG, FR ;
BENOWITZ, LI ;
GILBERT, JM .
JOURNAL OF NERVOUS AND MENTAL DISEASE, 1987, 175 (05) :306-308
[32]   Obstetric complications and schizophrenia - Two case-control studies based on structured obstetric records [J].
Kendell, RE ;
McInneny, K ;
Juszczak, E ;
Bain, M .
BRITISH JOURNAL OF PSYCHIATRY, 2000, 176 :516-522
[33]   OBSTETRICAL COMPLICATIONS AND TRAIL MAKING DEFICITS DISCRIMINATE SCHIZOPHRENICS FROM UNAFFECTED SIBLINGS AND CONTROLS [J].
KINNEY, DK ;
YURGELUNTODD, DA ;
WATERNAUX, CM ;
MATTHYSSE, S .
SCHIZOPHRENIA RESEARCH, 1994, 12 (01) :63-73
[34]   Inverse relationship of perinatal complications and eye tracking dysfunction in relatives of patients with schizophrenia: Evidence for a two-factor model [J].
Kinney, DK ;
Levy, DL ;
Yurgelun-Todd, DA ;
Tramer, SJ ;
Holzman, PS .
AMERICAN JOURNAL OF PSYCHIATRY, 1998, 155 (07) :976-978
[35]   Do obstetric complications cause the earlier age at onset in male than female schizophrenics? [J].
Kirov, G ;
Jones, PB ;
Harvey, I ;
Lewis, SW ;
Toone, BK ;
Rifkin, L ;
Sham, P ;
Murray, RM .
SCHIZOPHRENIA RESEARCH, 1996, 20 (1-2) :117-124
[36]   Obstetric complications and Apgar score in early-onset schizophrenic patients with prominent positive and prominent negative symptoms [J].
Kotlicka-Antczak, M ;
Gmitrowicz, A ;
Sobów, TM ;
Rabe-Jablonska, J .
JOURNAL OF PSYCHIATRIC RESEARCH, 2001, 35 (04) :249-257
[37]  
KUNUGI H, 1995, AM J PSYCHIAT, V152, P450
[38]   OBSTETRIC COMPLICATIONS, NEURODEVELOPMENTAL DEVIANCE, AND RISK OF SCHIZOPHRENIA [J].
LEWIS, SW ;
MURRAY, RM .
JOURNAL OF PSYCHIATRIC RESEARCH, 1987, 21 (04) :413-421
[39]  
Machon RA, 1997, ARCH GEN PSYCHIAT, V54, P322
[40]   Advancing paternal age and the risk of schizophrenia [J].
Malaspina, D ;
Harlap, S ;
Fennig, S ;
Heiman, D ;
Nahon, D ;
Feldman, D ;
Susser, ES .
ARCHIVES OF GENERAL PSYCHIATRY, 2001, 58 (04) :361-367