Obstetric Complications Scale Research Articles

Association of family history of schizophrenia and history of obstetric complications at birth: relationship with age at onset and psychopathology dimensions in a Nigerian cohort.

The nature of the association between obstetric complications (OCs) at birth and the genetic aetiology of schizophrenia remains unclear, as some authors suggest that it is an independent risk factor while others support either interactionism or an epiphenomenon perspective. To examine the association of family history of schizophrenia (FHS) with history of OCs, with a view to assessing whether this relationship moderates clinical phenotypes such as symptom dimensions and age at onset of illness. This study examined OCs among schizophrenia probands using the Obstetric Complications Scale. An inquiry into family history was performed using the Family history method. Psychopathological symptom dimensions were assessed using standard scales. Data were analyzed to examine the interaction of FHS and history of OCs with age at onset and symptom dimensions, using ANCOVA. FHS was significantly associated with the disorganized symptoms dimension (p=0.03). History of OCs was significantly associated with earlier age at onset (p=0.007). However, in ANCOVA, the effect of the interaction between FHS and history of OCs was not significant for age at onset and symptom dimensions (P = 0.059). FHS was significantly associated with disorganization syndrome, and OCs was significantly associated with age at onset.

Prolonged Methamphetamine-Induced Psychosis: Difference With Schizophrenia

The main objective of the present study was to compare the distribution of underlying factors such as neurological soft signs, obstetric complications, and family history of psychiatric disorders between two groups of schizophrenic patients and patients with prolonged methamphetamine-induced psychosis. In a case-control study, 30 patients with prolonged methamphetamine-induced psychosis and 30 patients with schizophrenia were selected. Data were collected through a demographic questionnaire, the Buchanan and Heinrichs’ Neurological Evaluation Scale (NES), the Lewis-Murray’s Obstetric Complications Scale (LMOCS), and the Weissman’s Family History Screen (FHS). Mean scores of the neurological soft signs (±SD) in the two groups of schizophrenic patients and patients with prolonged methamphetamine-induced psychosis were 15.7±8.7 and 11.7±6.2, respectively (P=0.040), and a significant difference was observed in the sensory integration between the two groups (P=0.022). Obstetric complications revealed similar distributions in the two groups. Patients with prolonged methamphetamine-induced psychosis reported higher prevalence of alcohol and other substances use disorders (P=0.003 and P=0.001, respectively) in their close relatives; however, the distributions of other disorders were not statistically different between the two groups’ close relatives. Similarities and differences in certain aspects were observed between the two groups, suggesting susceptibility for psychosis in patients with prolonged methamphetamine-induced psychosis; yet we found diversities that distinguish the two disorders.
 © 2019 Tehran University of Medical Sciences. All rights reserved.
 Acta Med Iran 2019;57(4):235-243

A history of obstetric complications is associated with the risk of progression from an at risk mental state to psychosis

ObjectiveClinical criteria for diagnosing Clinical High Risk for psychosis are now available. However, an understanding of the factors modulating the risk of subsequent development of frank psychosis in “at risk” individuals remains elusive. The aim of the study was to identify associations between obstetric history and the development of psychotic disorders in individuals with an At Risk Mental State (ARMS). MethodsObstetric data was obtained from the medical records of 82 individuals meeting ARMS criteria. The participants were followed up for a mean period of 42.3 (±28.3) months for transition to psychosis. ResultsA history of at least one obstetric complication (OC) endorsed as definite on the Lewis and Murray Obstetric Complications Scale was found to be associated with increased risk of transition to schizophrenia (OR: 6.57, 95% CI:1.89–22.85). The number of definite OCs was found to be positively correlated with the proportion of converters (p<0.0001). The probability of conversion to schizophrenia was found to increase with a decrease of Apgar-1 and Apgar-5 scores (ORs: 0.40, 95% CI:0.22–0.74 and 0.25, 95% CI:0.10–0.63, respectively). ConclusionsThe findings emphasise the potential value of including obstetric data in algorithms estimating the likelihood of transition of an ARMS to full-blown psychosis.

Obstetric complications as a risk factor for first psychotic episodes in childhood and adolescence

There are reports of significant association between obstetric complications (OC) and childhood psychosis. Authors conducted a case-control study of 102 children and adolescents with a first episode psychosis (FEP) and 94 healthy controls (HC), using the obstetric complications scale (OCS) and their medical records, to examine the risk of FPE. Patients were recruited from child and adolescent psychiatry units at six university hospitals and controls from publicly-funded schools of similar characteristics and from the same geographic areas. A logistic regression was performed to quantify the risk of psychosis in childhood and adolescence, based on OC, adjusting for potential confounding factors like socio economic status (SES) and family psychiatric history (FPH). OC appeared more frequently in the records of patients. Significant differences between patients and controls were found in Prenatal OC (15.7% vs. 5.3%, P < 0.05) and among them, bleeding in pregnancy showed the greatest difference between groups (12.7% vs. 2.1%, P < 0.01). In the logistic regression, bleeding in pregnancy showed a crude odds ratio (OR) of 6.7 (95%CI = 1.4-30.6) and 5.1 (CI 95% = 1.0-24.9) adjusted for SES and FPH. Therefore, bleeding in pregnancy is a likely risk factor for early-onset psychosis.

The Nithsdale schizophrenia surveys. X: Obstetric complications, family history and abnormal movements.

Obstetric histories of 54 schizophrenic patients and 114 siblings were obtained from their mothers and scored using the Obstetric Complications Scale. There were no statistically significant difference in the proportion of schizophrenic patients (35%) and siblings (29%) who had at least one definite obstetric complication. There was no evidence that schizophrenic patients with a history of obstetric complications were less likely to have a first-degree relative with a history of psychiatric illness leading to in-patient care. Schizophrenic patients with a history of obstetric complications were more likely to have drug-induced Parkinsonism. There was a trend for tardive dyskinesia to be more common in those schizophrenic patients with no obstetric complications but a family history of schizophrenia.

83 THE RELATION BETWEEN OBSTETRIC FACTORS, CULTURAL FACTORS AND NEWBORN BEHAVIOR

This study examines the effects of cultural and biomedical variables on newborn development by comparing a sample of Irish (n=48) and American (n=54) newborns on the Brazelton scale on day 1 and day 3. The contribution of biomedical variables was assessed by the Obstetric Complications Scale (Parmelee et al., 1976), so that subjects were selected on a basis of comparable obstetric histories. By controlling for as many confounding obstetric stress variables as possible, we were able to assess the contribution of other factors on newborn behavior. Labor and delivery management practices were therefore compared in both settings. Using the 7-point cluster scoring system developed by Lester et al. (1978), results showed that Irish infants scored significantly higher on the Orientation, Range of State, and Autonomic Regulation clusters. They were more responsive to both visual and auditory stimuli, were predominantly in quiet alert states, and showed fewer signs of physiological stress than American infants. These results may suggest that the forms of childbirth environments and different cultural attitudes towards pregnancy, labor and delivery have an effect on newborn behavior. We were therefore able to raise the possibility that the superior performance of the Irish infants in these areas may be due to the provision of an extremely supportive psychological environment with minimal technological intervention during labor and delivery.

THE RELATIONSHIP OF MEDICAL EVENTS TO DEVELOPMENT IN A GROUP OF PRETERM INFANTS

It has long been known that the occurrence of perinatal complications shows an association with fetal and neonatal mortality. The infant who survives such events is presumed to be at risk for later development disability. Prior to this report no work had been done to show whether a quantitative relationship between the number of perinatal complications and outcome actually existed.This study involved the use of a 41 item Obstetric Complications Scale (OCS) and a 10 item Postnatal Complications Scale (PCS) to see if such a correlation could be shown. 135 preterm infants with variable frequencies of prenatal, intrapartum and postnatal complications were enrolled. All had Resell examinations at 9 and 24 months and a Bayley examination at 18 months. Ages were corrected for prematurity.For the whole group there was no correlation between the OCS/PCS and the tests at 9, 18, 24 months. Infants with low developmental scores were not more inclined to have higher rates of perinatal complications. 5 who were found later to have cerebral palsy had very poor OCS/PCS scores but could not be distinguished in the newborn period from a larger group with equally low perinatal scores but normal later development.This study shows the difficulties associated with trying to predict disability from data acquired solely in the perinatal period. The need to continue evaluation during infancy can not be stressed enough.