Preterm birth and psychiatric disorder in young adult life

TY - JOUR

T1 - Preterm birth and psychiatric disorder in young adult life

AU - Nosarti, Chiara

AU - Reichenberg, Abraham

AU - Murray, Robin M.

AU - Cnattingius, Sven

AU - Lambe, Mats P.

AU - Yin, Li

AU - MacCabe, James

AU - Rifkin, Larry

AU - Hultman, Christina M.

PY - 2012/6

Y1 - 2012/6

N2 - Context: Preterm birth, intrauterine growth restriction, and delivery-related hypoxia have been associated with schizophrenia. It is unclear whether these associations pertain to other adult-onset psychiatric disorders and whether these perinatal events are independent.Objective: To investigate the relationships among gestational age, nonoptimal fetal growth, Apgar score, and various psychiatric disorders in young adult life.Design: Historical population-based cohort study.Setting: Identification of adult-onset psychiatric admissions using data from the National Board of Health and Welfare, Stockholm, Sweden.Participants: All live-born individuals registered in the nationwide Swedish Medical Birth Register between 1973 and 1985 and living in Sweden at age 16 years by December 2002 (n=1 301 522).Main Outcome Measures: Psychiatric hospitalization with nonaffective psychosis, bipolar affective disorder, depressive disorder, eating disorder, drug dependency, or alcohol dependency, diagnosed according to the International Classification of Diseases codes for 8 through 10. Cox proportional hazards regression models were used to estimate hazard ratios and 95% CIs.Results: Preterm birth was significantly associated with increased risk of psychiatric hospitalization in adulthood (defined as >= 16 years of age) in a monotonic manner across a range of psychiatric disorders. Compared with term births (37-41 weeks), those born at 32 to 36 weeks' gestation were 1.6 (95% CI, 1.1-2.3) times more likely to have nonaffective psychosis, 1.3 (95% CI, 1.1-1.7) times more likely to have depressive disorder, and 2.7 (95% CI, 1.6-4.5) times more likely to have bipolar affective disorder. Those born at less than 32 weeks' gestation were 2.5 (95% CI, 1.0-6.0) times more likely to have nonaffective psychosis, 2.9 (95% CI, 1.8-4.6) times more likely to have depressive disorder, and 7.4 (95% CI, 2.7-20.6) times more likely to have bipolar affective disorder.Conclusions: The vulnerability for hospitalization with a range of psychiatric diagnoses may increase with younger gestational age. Similar associations were not observed for nonoptimal fetal growth and low Apgar score.

AB - Context: Preterm birth, intrauterine growth restriction, and delivery-related hypoxia have been associated with schizophrenia. It is unclear whether these associations pertain to other adult-onset psychiatric disorders and whether these perinatal events are independent.Objective: To investigate the relationships among gestational age, nonoptimal fetal growth, Apgar score, and various psychiatric disorders in young adult life.Design: Historical population-based cohort study.Setting: Identification of adult-onset psychiatric admissions using data from the National Board of Health and Welfare, Stockholm, Sweden.Participants: All live-born individuals registered in the nationwide Swedish Medical Birth Register between 1973 and 1985 and living in Sweden at age 16 years by December 2002 (n=1 301 522).Main Outcome Measures: Psychiatric hospitalization with nonaffective psychosis, bipolar affective disorder, depressive disorder, eating disorder, drug dependency, or alcohol dependency, diagnosed according to the International Classification of Diseases codes for 8 through 10. Cox proportional hazards regression models were used to estimate hazard ratios and 95% CIs.Results: Preterm birth was significantly associated with increased risk of psychiatric hospitalization in adulthood (defined as >= 16 years of age) in a monotonic manner across a range of psychiatric disorders. Compared with term births (37-41 weeks), those born at 32 to 36 weeks' gestation were 1.6 (95% CI, 1.1-2.3) times more likely to have nonaffective psychosis, 1.3 (95% CI, 1.1-1.7) times more likely to have depressive disorder, and 2.7 (95% CI, 1.6-4.5) times more likely to have bipolar affective disorder. Those born at less than 32 weeks' gestation were 2.5 (95% CI, 1.0-6.0) times more likely to have nonaffective psychosis, 2.9 (95% CI, 1.8-4.6) times more likely to have depressive disorder, and 7.4 (95% CI, 2.7-20.6) times more likely to have bipolar affective disorder.Conclusions: The vulnerability for hospitalization with a range of psychiatric diagnoses may increase with younger gestational age. Similar associations were not observed for nonoptimal fetal growth and low Apgar score.

KW - OBSTETRIC COMPLICATIONS

KW - PERINATAL RISK-FACTORS

KW - BIPOLAR DISORDER

KW - AFFECTIVE PSYCHOSIS

KW - SWEDISH NATIONAL COHORT

KW - BORN PRETERM

KW - SCHOOL PERFORMANCE

KW - BRAIN VOLUMES

KW - FETAL-GROWTH

KW - GESTATIONAL-AGE

U2 - 10.1001/archgenpsychiatry.2011.1374

DO - 10.1001/archgenpsychiatry.2011.1374

M3 - Article

SN - 2168-622X

VL - 69

SP - 610

EP - 617

JO - JAMA Psychiatry

JF - JAMA Psychiatry

IS - 6

ER -