Abstract
Whether severe obstetric complications (OCs), which harm neural function in offspring, contribute to impaired cognition found in psychiatric disorders is currently unknown. Here, we sought to evaluate how a history of severe OCs is associated with cognitive functioning, indicated by Intelligence Quotient (IQ). We evaluated the associations of a history of OCs and IQ in 622 healthy controls (HC) and 870 patients on the schizophrenia (SCZ) - bipolar disorder (BIP) spectrum from the ongoing Thematically Organized Psychosis study cohort, Oslo, Norway. Participants underwent assessments using the NART (premorbid IQ) and the WASI (current IQ). Information about OCs was obtained from the Medical Birth Registry of Norway. Multiple linear regression models were used for analysis. Severe OCs were equally common across groups. SCZ patients with OCs had lower performances on both premorbid and current IQ measures, compared to those without OCs. However, having experienced more than one co-occurring severe OC was associated with lower current IQ in all groups. Severe OCs were associated with lower IQ in the SCZ group and in the BIP and HC groups, but only if they had experienced more than one severe OC. Low IQ might be a neurodevelopmental marker for SCZ; wherein, severe OCs influence cognitive abilities and increase the risk of developing SCZ. Considering OCs as a variable of neurodevelopmental risk for severe mental illness may promote the development of neuroprotective interventions, improve outcome in vulnerable newborns and advance our ability to make clinical prognoses.
Highlights
Exposure to a broad category of adversities during the fetal period or delivery, called obstetric complications (OCs), increases schizophrenia risk 1.5–5 fold (Cannon et al, 2002b; Geddes and Lawrie, 1995; Nosarti et al, 2012; Pugliese et al, 2019)
We found severe OCs to be common across groups, and the number of OCs co-occurring was similar
To have experienced more than two co-occurring OCs was associated with lower premorbid Intelligence Quotient (IQ) in both patients within the schizophrenia group and healthy controls, but not in the bipolar group
Summary
Exposure to a broad category of adversities during the fetal period or delivery, called obstetric complications (OCs), increases schizophrenia risk 1.5–5 fold (Cannon et al, 2002b; Geddes and Lawrie, 1995; Nosarti et al, 2012; Pugliese et al, 2019). The influence of OCs in the risk for developing bipolar disorders is less clear (Nosarti et al, 2012; Pugliese et al, 2019; Scott et al, 2006). Whether severe obstetric complications (OCs), which harm neural function in offspring, contribute to impaired cognition found in psychiatric disorders is currently unknown. We sought to evaluate how a history of severe OCs is associated with cognitive functioning, indicated by Intelligence Quotient (IQ). We evaluated the associations of a history of OCs and IQ in 622 healthy controls (HC) and 870 patients on the schizophrenia (SCZ) – bipolar disorder (BIP) spectrum from the ongoing Thematically Organized Psychosis study cohort, Oslo, Norway. Low IQ might be a neurodevelopmental marker for SCZ; wherein, severe OCs influence cognitive abilities and increase the risk of developing SCZ. Considering OCs as a variable of neurodevelopmental risk for severe mental illness may promote the development of neuroprotective interventions, improve outcome in vulnerable newborns and advance our ability to make clinical prognoses
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