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The role of perinatal problems in risk of co-morbid psychiatric and medical disorders in adulthood

Published online by Cambridge University Press:  02 May 2007

YOKO NOMURA ,
JEANNE BROOKS-GUNN ,
CHARLES DAVEY ,
JACOB HAM  and
WILLIAM P. FIFER
YOKO NOMURA*
Affiliation:
Mount Sinai School of Medicine, New York, NY, USA
JEANNE BROOKS-GUNN
Affiliation:
Teachers College, Columbia University, New York, USA Columbia University College of Physicians and Surgeons, New York, USA
CHARLES DAVEY
Affiliation:
The School at Columbia University, New York, USA
JACOB HAM
Affiliation:
Beth Israel Medical Center and Albert Einstein College of Medicine, New York, NY, USA
WILLIAM P. FIFER
Affiliation:
Columbia University College of Physicians and Surgeons, New York, USA New York State Psychiatric Institute, New York, NY, USA Sackler Institute for Developmental Psychobiology, New York, NY, USA
*
*Address for correspondence: Yoko Nomura, Ph.D., M.P.H., Department of Psychiatry, Mount Sinai School of Medicine, One Gustav L. Levy Place, Box 1230, New York, NY10029, USA. (Email: [email protected])
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Abstract

Background

Perinatal problems may be associated with an increased risk for psychological and physical health problems in adulthood, although it is unclear which perinatal problems (low birthweight, preterm birth, low Apgar scores, and small head circumference), or what clusters of problems, are more likely to be associated with later health problems. It is also not known whether perinatal problems (singly or together) are associated with co-morbidity between psychological and physical health problems.

Method

A regional random sample (from Baltimore) of mothers and their children (n=1525) was followed from birth to adulthood (mean age 29 years). Perinatal conditions were measured at delivery. Psychological problems (depression and suicidal ideation) were measured with the General Health Questionnaire-28 (GHQ-28) and physical problems (asthma and hypertension) with the RAND-36 Health Status Inventory.

Results

Children with perinatal problems were generally at increased risk for depression, suicidal ideation and hypertension, and co-morbid depression and hypertension even after controlling for confounders. One possible underlying condition, preterm low birthweight (LBW), extracted by cluster analysis, considering all of the four perinatal problems, was associated with increased risk for psychological and physical health outcomes as well as co-morbidity of the two.

Conclusions

LBW, preterm birth and small head circumference singly increased the risk for both psychological and physical health problems, as well as co-morbid depression and hypertension, while low Apgar scores were only associated with psychological problems. Delineating different etiological processes, such as preterm LBW, considering various perinatal problems simultaneously, might be of benefit to understanding the fetal origin of adult illness and co-morbidity.

Type
Original Article
Information
Psychological Medicine , Volume 37 , Issue 9 , September 2007 , pp. 1323 - 1334
Copyright
Copyright © Cambridge University Press 2007

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