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Schizophrenia Bulletin 1999 25(3):425-435;
© 1999 by Oxford University Press and the Maryland Psychiatric Research Center (MPRC)
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© Oxford University Press

Does Preexisting Abnormality Cause Labor-Delivery Complications in Fetuses Who Will Develop Schizophrenia?

Thomas F. McNeil, Ph.D. and Elizabeth Cantor-Graae, Ph.D.
Professor, Section for Epidemiology, Department of Community Medicine, Lund University, Malmö University Hospital (MAS) Malmö, Sweden
Associate Professor, Section for Epidemiology, Department of Community Medicine, Lund University, Malmö University Hospital (MAS) Malmö, Sweden

Reprint requests should be sent to Dr. T.F. McNeil, Section for Epidemiology, Department of Community Medicine, Malmö University Hospital, S-205 02 Malmö, Sweden

Many authors have suggested that theoretically the labor-delivery complications (LDCs) that frequently appear in the histories of individuals with schizophrenia represent the secondary consequence of preexistent abnormality in the fetus. The question of whether LDCs are systematically associated with prenatal complications and fetal abnormality was studied in 70 singleton schizophrenia patients, in 23 monozygotic twin pairs discordant and 10 pairs concordant for schizophrenia, and in 33 individuals with inferred genetic risk for schizophrenia. Schizophrenia cases with signs of prenatal abnormality (reduced head size, increased minor physical anomalies, greater within-twin-pair birthweight differences) did not have more LDCs than other schizophrenia cases. LDCs were not more frequent in genetic-risk cases with congenital malformations than in genetic-risk cases without malformations. Instead, individuals with schizophrenia who had a history of abnormal length of labor had significantly fewer pregnancy complications and minor physical anomalies than did other individuals with schizophrenia. No support was found for suggestions that LDCs among individuals who have not yet developed schizophrenia are the result of identifiable preexistent fetal abnormality.

Keywords: Fetus / schizophrenia / obstetric complications / minor physical anomalies / birth / twins


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