© 1999 by Oxford University Press and the Maryland Psychiatric Research Center (MPRC)
Schizophrenia and Complications of Pregnancy and Labor: An Individual Patient Data Meta-analysis
Senior Clinical Research Fellow, University Department of Psychiatry, Warneford Hospital Oxford, U.K.
Lecturer, University Victor Segalen Bordeaux, France
Senior Lecturer, Department of Psychological Medicine, Institute of Psychiatry London, U.K.
Senior Clinical Research Fellow, University Department of Psychiatry, Kennedy Tower, Royal Edinburgh Hospital Edinburgh, Scotland
Médecin Adjoint, Département Universitaire de Psychiatrie Adulte Lausanne, Switzerland
Consultant Psychiatrist, Cornhill Hospital Aberdeen, Scotland
Senior Lecturer, Psychiatrische Universitätsklinik, and Deputy Director, Department of Psychiatry, Rheinische Friedrich Wilhelms University Bonn, Germany
Director, Department of Clinical Research, Crichton Royal Hospital Dumfries, Scotland
Head, Unit for Medical Risk Research, University of Lund Malmö, Sweden
Consultant Psychiatrist, Cluain Mhuire Family Centre Blackrock, Co. Dublin, Ireland
Senior Physician, Psychiatrischen Klinik und Poliklinik, Universität Wurzbürg, Germany
University Assistant of the University of Vienna, Department of General Psychiatry, University Hospital for Psychiatry Vienna, Austria
Professor, Department of Psychological Medicine, Institute of Psychiatry and Guy's, King's, and St. Thomas' Medical School London, U.K.
Reprint requests should be sent to Dr. J.R. Geddes, University Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX, U.K.; e-mail: john.geddes{at}psychiatry.ox.ac.uk
Several epidemiological studies have reported an association between complications of pregnancy and delivery and schizophrenia, but none have had sufficient power to examine specific complications that, individually, are of low prevalence. We, therefore, performed an individual patient meta-analysis using the raw data from case control studies that used the Lewis-Murray scale. Data were obtained from 12 studies on 700 schizophrenia subjects and 835 controls. There were significant associations between schizophrenia and premature rupture of membranes, gestational age shorter than 37 weeks, and use of resuscitation or incubator. There were associations of borderline significance between schizophrenia and birthweight lower than 2,500 g and forceps delivery. There was no significant interaction between these complications and sex. We conclude that some abnormalities of pregnancy and delivery may be associated with development of schizophrenia. The pathophysiology may involve hypoxia and so future studies should focus on the accurate measurement of this exposure.
Keywords: Obstetric complications / aetiology / epidemiology
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