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Published on: June 15, 2011
Fetal growth and schizophrenia: a nested case-control and case-sibling study
Philip Rising Nielsen1, Preben Bo Mortensen, Christina Dalman
1To whom correspondence should be addressed; National Centre for Register-Based Research, Aarhus University, Taasingegade 1, DK-8000 Aarhus C, Denmark; tel: +45-8716-5753, fax: +45-8716-4601,
Insights
Children born small for gestational age (SGA) have a modestly increased risk of developing schizophrenia. This association appears linked to factors related to low birth weight itself, not shared family influences.
Area of Science:
- Psychiatry
- Perinatal Medicine
- Epidemiology
Background:
- Low birth weight is a suspected risk factor for schizophrenia.
- Small for gestational age (SGA) serves as a proxy for intrauterine growth restriction.
Purpose of the Study:
- To investigate the association between SGA birth and schizophrenia risk.
- To determine if shared sibling factors mediate the SGA-schizophrenia link.
Main Methods:
- Linked Danish population-based registers (Medical Birth, Psychiatric, Civil Registration).
- Nested case-control and case-sibling study designs.
- Conditional logistic regression to estimate incidence rate ratios (IRRs).
Main Results:
- SGA was associated with an increased schizophrenia risk (IRR 1.23 in case-control).
- The case-sibling study showed a similar trend (IRR 1.28).
- The association appears independent of shared familial factors.
Conclusions:
- A modest association exists between SGA and schizophrenia.
- The findings suggest an independent effect of SGA on schizophrenia risk.
- Shared sibling factors do not explain the observed association.
Abstract:
The association between low birth weight and schizophrenia has been suggested by many studies. Small for gestational age (SGA) is a measure used as a proxy for intrauterine growth restriction. We aim to examine if children who are born SGA are at increased risk of developing schizophrenia and whether an association may be explained by factors shared among siblings. We linked 3 population-based registers: the Danish National Medical Birth Register, the Danish Psychiatric Central Register, and the Danish Civil Registration register to identify all persons born between 1978 and 2000. A nested case-control study and a case-sibling study design were used. There were 4650 cases of schizophrenia. Incidence rate ratios (IRRs) were estimated using conditional logistic regression. SGA was defined as the lowest 10th birth weight percentile for a given sex and gestational age. SGA was associated with an IRR of 1.23 (95% CI: 1.11-1.37) for schizophrenia in the case-control study. An IRR of 1.28 (95% CI: 0.97-1.68) was found in the case-sibling study. There is a modest association between SGA and schizophrenia. Our results indicate that this association is due to an independent effect of factors associated with low birth weight for gestational age per se, rather than other factors shared by siblings.
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