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Obstetric complications and risk for severe psychopathology in childhood
W W Eaton1, P B Mortensen, P H Thomsen
1Department of Mental Hygiene, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Maryland 21205, USA. weaton@jhsph.edu
Insights
Obstetric complications are linked to childhood mental disorders requiring hospitalization. Factors like birth weight, growth rate, and Apgar scores were key predictors, supporting the continuum of reproductive casualty hypothesis.
Area of Science:
- Perinatal Medicine
- Child Psychiatry
- Epidemiology
Background:
- Understanding the link between perinatal events and later mental health is crucial for early intervention.
- Previous research suggests a connection, but specific obstetric factors require further investigation.
Purpose of the Study:
- To investigate the association between obstetric complications and the risk of mental disorders leading to hospitalization in children under 15.
- To identify specific perinatal factors that predict childhood mental health outcomes.
Main Methods:
- Utilized Danish national registry data, linking birth records (1973-1993) with psychiatric hospitalization records.
- Employed a 10% reference population for comparison.
- Categorized diagnoses into seven broad groups for analysis.
Main Results:
- Obstetric complications were associated with a spectrum of childhood mental disorders.
- The strongest predictors identified were the interaction of birth weight with growth speed and the 5-minute Apgar score.
- No specific diagnostic group showed a unique association with obstetric complications.
Conclusions:
- Findings support the continuum of reproductive casualty hypothesis, suggesting a link from perinatal events to mental health.
- Birth weight, growth dynamics, and immediate postnatal condition are significant indicators of later mental health risk.
- The study highlights the importance of monitoring perinatal factors for predicting and potentially preventing childhood mental disorders.
Abstract:
The purpose of the study was to assess the association of obstetric complications with risk for mental disorders resulting in hospitalization before the age of 15. Records from all births in Denmark from 1973 through 1993 were linked to records of all psychiatric hospitalizations. Diagnoses were grouped into seven broad categories. A reference population of 10% of births in Denmark from 1973 to 1990 was used for comparison. Obstetric complications were associated with the range of mental disorders occurring in childhood. The strongest predictors were a variable indicating the interaction of birth weight with speed of growth and the 5-minute Apgar score. There was no diagnostic group that stood out as different with respect to obstetric complications. These results are consistent with the hypothesis of the continuum of reproductive casualty.