Obstetric Complications

The significance of obstetric complications in the development of schizophrenia has led to some disagreement among researchers. In their 1978 review, McNeil and Kaij concluded that obstetric complications are not increased in the births of high-risk offspring [77]. A later meta-analysis arrived at a different conclusion: Sacker et al. found small but significant effect sizes indicating that ''the risk of obstetric complications is increased in the births to parents with schizophrenia'' [78]. Specifically, birth weights were lower, there were more birth complications and the baby's condition was poorer [78,79]. Schizophrenic women are thought to be at greater risk for complications because of the association between schizophrenia in young women and smoking, substance abuse and low socioeconomic status [78,79]. In addition to noting a higher incidence of obstetric complications in the births of schizophrenic mothers, complications have been explored as having a causal role in later development of schizophrenia in their offspring. Of all the obstetric variables studied, hypoxia shows the strongest association with later schizophrenia [80]. Compared to controls at low risk for schizophrenia, foetal hypoxia is associated with an increase in structural brain abnormalities in schizophrenic patients and their siblings [81]. Although hypoxia is associated with lower IQ, particularly in children with a schizophrenic parent, high-risk offspring and controls with suspected hypoxic insult did not significantly differ in overall IQ at the age of 7 [82].

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