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Preterm birth associated with adult-onset psychiatric disorders
Preterm birth was significantly associated with an increased risk of developing a range of psychiatric disorders in adulthood, according to new data.
Chiara Nosarti, PhD and colleagues from the United Kingdom and Sweden performed an historical population-based cohort study that included 1,301,522 individuals registered in the Swedish Medical Birth Register between 1973 and 1985 and living in Sweden at age 16 years by December 2002. Linkage analysis was performed with the Swedish hospital discharge register to identify all individuals with a primary or secondary diagnosis of nonaffective psychosis (n=669), depressive disorder (n=2,333), bipolar affective disorder (n=217), eating disorder (n=997), drug dependence (n=2,973) and alcohol dependence (n=3,334).
According to the researchers, summaries of the data were calculated for the total cohort and in relation to unadjusted incidence rates per 10,000 person-years of hospitalization with the psychiatric diagnoses. Using Cox proportional hazards regression models, the researchers determined the association between perinatal factors — such as gestational age, nonoptimal fetal growth and Apgar score — and risk of individual psychiatric diagnoses.
Compared with term births, those born at less than 32 weeks’ gestation were 7.4 (95% CI, 2.7-20.6) times more likely to have bipolar disorder, 2.9 (95% CI, 1.8-4.6) times more likely to have depressive disorder and 2.5 (95% CI, 1.0-6.0) times more likely to have nonaffective psychosis. Those born at 32 to 36 weeks’ gestation were 1.6 (95% CI, 1.1-2.3) times more likely to have nonaffective psychosis, 1.3 (95% CI, 1.1-1.7) times more likely to have depressive order and 2.7 (95% CI, 1.6-4.5) times more likely to have bipolar affective disorder than those born at term.
The researchers said the association between preterm birth and increased risk for psychiatric disorders may be attributable to brain development in children born before a full 40-week gestation period.
“The theory that preterm birth is associated with impaired neurodevelopment has biological plausibility,” they wrote. “The immature nervous system is especially vulnerable to neonatal brain injury, which may result in alteration of the programmed corticogenesis of the developing brain.”
Disclosure: The study was supported by a Young Investigator Award from the National Alliance for Research on Schizophrenia and Depression. The researchers report no relevant financial disclosures.
