Risk of schizophrenia spectrum and affective disorders associated with small for gestational age birth and height in adulthood

Anthropometry in antipsychotic-naïve first-episode psychosis patients: An exploratory approach to the role of environmental early life events in two independent samples

BACKGROUND

Patients with schizophrenia exhibit a reduced life expectancy mainly due to medical-related pathologies which might have been initiated due to stressful events during fetal development. Indeed, intra-uterus growth patterns predict anthropometric measures in adulthood, describing risk factors for schizophrenia and metabolic disorders. We aim to evaluate anthropometric values in two cohorts of antipsychotic-naïve first-episode episode psychosis (FEP) and correlated them with surrogate markers of the fetal environment such as birth weight (BW) and season of birth.

METHODS

BW, season of birth, and anthropometric values from 2 cohorts of FEP patients (Barcelona and Santander) were evaluated. In cohort B, 91 patients, and 110 controls while in cohort S, 644 and 235 were included respectively.

RESULTS

Patients were shorter, slimmer, and with lower BMI compared with controls. In both cohorts, patients, and female patients born in winter displayed the shortest height. Regarding BW, height was significantly associated with the interaction of diagnosis and BW in the whole sample and the male subsample.

CONCLUSIONS

Our results confirm reduced anthropometric features in FEP at onset while suggesting the influence of winter birth and BW, highlighting the role of early life events in the later outcome of FEP with sex differences.

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

OBJECTIVE

Clinical 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).

METHODS

Obstetric 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.

RESULTS

A 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).

CONCLUSIONS

The findings emphasise the potential value of including obstetric data in algorithms estimating the likelihood of transition of an ARMS to full-blown psychosis.

Effect of Prematurity on Cerebellar Growth

The aim of this study was to evaluate cerebellar growth of preterm infants. Vermis height and transverse cerebellar diameter were measured by cranial ultrasonography in 38 preterm infants (27-32 weeks) at birth and term equivalent age. Measurements were compared with 40 term appropriate-for-gestational-age infants. Preterms at term equivalent age had larger vermis height than term infants (2.39 ± 0.25 cm vs 2.25 ± 0.18 cm, P = .005), whereas no significant difference was found in the transverse cerebellar diameter (5.32 ± 0.38 cm vs 5.44 ± 0.23 cm, P = .13). Vermis height and transverse cerebellar diameter of appropriate-for-gestational-age preterm infants (n = 29) were found larger than small-for-gestational-age ones (n = 9). Vermis height and transverse cerebellar diameter at term equivalent age of appropriate-for-gestational-age preterm infants born before and after 29 weeks of age showed no significant difference. Cerebellar growth is preserved in extreme preterms. However, being small for gestational age may have deleterious effects on cerebellar development.