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Macrosomia and psychiatric risk in adolescence
Ryan J Van Lieshout1, Calan D Savoy2, Mark A Ferro3
1Department of Psychiatry and Behavioural Neurosciences, St. Joseph's Healthcare Hamilton, McMaster University, West 5th Campus, 100 West 5th Street, Hamilton, ON, L8N 3K7, Canada. vanlierj@mcmaster.ca.
Insights
Infants born with high birth weight (macrosomia) face increased risks for conduct disorder, oppositional defiant disorder, and ADHD in adolescence. These risks are higher for males and those with socioeconomic disadvantages.
Area of Science:
- Developmental Psychology
- Pediatric Psychiatry
- Public Health
Background:
- The prenatal environment significantly impacts mental health.
- While low birth weight is linked to psychopathology, high birth weight (macrosomia) also presents suboptimal intrauterine conditions, potentially increasing mental health risks.
- Macrosomic births are increasingly prevalent, necessitating research into associated mental health outcomes.
Purpose of the Study:
- To investigate the association between macrosomia and psychiatric disorders in adolescents.
- To identify specific mental health risks associated with high birth weight.
- To inform theories of etiology, prediction, and prevention of childhood psychiatric disorders.
Main Methods:
- Utilized data from the 2014 Ontario Child Health Study (OCHS).
- Assessed psychiatric disorders in adolescents (N=2151, aged 12-17) using the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID).
- Compared mental disorder rates between macrosomic (>4000g) and normal birth weight (NBW; 2500-4000g) groups, adjusting for covariates like age, sex, SES, parental mental health, and gestational diabetes.
Main Results:
- Adolescents born macrosomic showed significantly higher odds of conduct disorder (CD), oppositional defiant disorder (ODD), and ADHD after covariate adjustment.
- Males born macrosomic exhibited a greater likelihood of psychiatric problems compared to females.
- Socioeconomic disadvantage exacerbated the risk of ODD, ADHD, major depressive disorder, and generalized anxiety disorder in macrosomic individuals.
Conclusions:
- Macrosomia is associated with an elevated risk of externalizing problems during adolescence.
- The findings highlight specific vulnerabilities, particularly in adolescent males and those from socioeconomically disadvantaged backgrounds.
- Understanding these associations can guide targeted interventions for at-risk populations.
Abstract:
The prenatal environment can exert important effects on mental health. While much research has linked low birth weight to psychopathology, the intrauterine environment associated with high birth weight (macrosomia; > 4000 g) is also sub-optimal and may increase risk. Given the increasing prevalence of macrosomic births, understanding the mental health outcomes of infants born macrosomic can help refine theories of etiology, predict disorder, and target preventive interventions. Using data from the 2014 Ontario Child Health Study (OCHS), we examined the risk for psychiatric disorders in adolescents born macrosomic. Youth (N = 2151) aged 12-17 years completed the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID). Rates of common mental disorders assessed by the MINI-KID were compared between those born at normal birth weight (NBW; 2500-4000 g, n = 1817) and adolescents born macrosomic (> 4000 g, n = 334). These associations were then adjusted for participant age, sex, socioeconomic status (SES) of the family, parental mental health, and gestational diabetes mellitus. After adjustment for covariates, adolescents born macrosomic had higher odds of conduct disorder (CD; OR = 3.19, 95% CI: 1.37-7.43), oppositional defiant disorder (ODD; OR = 1.79, 95% CI: 1.11-2.91), and ADHD (OR = 1.77, 95% CI: 1.21-2.80). Moderation analyses revealed that males born macrosomic were more likely to have psychiatric problems than their female peers. Socioeconomic disadvantage also amplified the risk posed by macrosomia for ODD, ADHD, major depressive disorder, and generalized anxiety disorder. In this study, macrosomia was associated with an increased risk of clinically significant externalizing problems in adolescence, most notably among boys and those facing socioeconomic disadvantage.
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