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Fetal Growth Restriction and Schizophrenia: A Swedish Twin Study

Published online by Cambridge University Press:  21 February 2012

Emma Nilsson*
Affiliation:
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. [email protected]
Gabriella Stålberg
Affiliation:
Department of Neuroscience, Psychiatry, Ulleråker, Uppsala University, Uppsala, Sweden.
Paul Lichtenstein
Affiliation:
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Sven Cnattingius
Affiliation:
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Petra Otterblad Olausson
Affiliation:
The National Board of Health and Welfare, Stockholm, Sweden.
Christina M. Hultman
Affiliation:
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Neuroscience, Psychiatry, Ulleråker, Uppsala University, Uppsala, Sweden.
*
*Address for correspondence: Emma Nilsson, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, SE-171 77 Stockholm.

Abstract

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Obstetric complications increase the risk of schizophrenia. However, it is not known whether there is a causal relation or whether the association is mediated by genetic and/or shared environmental effects. The aim of this study was to investigate the associations between birthweight, other birth characteristics, and schizophrenia. Twin pairs discordant for schizophrenia will also control for unmeasured genetic and shared environmental effects. Prospectively filed obstetric records were used for a cohort analysis of 11,360 same-sexed twins, and within–twin pair analyses were conducted on 90 twin pairs discordant for schizophrenia. The results from the cohort study showed that low birthweight (less than or equal to 1999 grams; odds ratio [OR] 1.67, 95% confidence interval [CI] 0.88–3.14 and 2000–2299 grams; OR 1.79, 95% CI 1.07–3.01) and small head circumference (less than or equal to 31.5 cm; OR 1.61, 95% CI 1.03–2.51) were associated with later development of schizophrenia. The associations remained in the within-pair analyses. The association between low birthweight and schizophrenia is partly a function of reduced fetal growth. Fetal growth restriction seems to be associated with risk of schizophrenia independently of familial factors.

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Articles
Copyright
Copyright © Cambridge University Press 2005