Obstetric Complications linked to Severe Psychopathology in Schizophrenia Spectrum Disorders, suggests study

"Our findings indicate that obstetric complications (OCs) are linked not only to a higher risk of developing psychosis but also to more severe symptoms," the researchers wrote. 

Obstetric complications, which include issues such as preeclampsia, low birth weight, and maternal infections during pregnancy, have long been a topic of interest in psychiatric research. Schizophrenia (SZ) is a serious mental health disorder influenced by gene-environment interactions, with obstetric complications increasing the risk of developing the condition. Recent research indicates that OCs may also worsen the symptoms of SZ.

Against the above background, Maria Florencia Forte, Bipolar and Depressive Disorders Unit, Hospital Clínic de Barcelona, Barcelona, Spain, and colleagues conducted a systematic review and meta-analysis to thoroughly assess the differences in psychopathology between individuals with and without exposure to OCs with schizophrenia and related disorders.

For this purpose, the researchers conducted a systematic search of PubMed, PsycINFO, and SCOPUS to identify eligible studies. They retrieved a total of 4,091 records through systematic and citation searches. Ultimately, 14 studies were included in the review, with 12 meeting the criteria for meta-analysis, involving 2,992 patients.

The investigation yielded the following insights:

• The analysis indicated that schizophrenia patients exposed to obstetric complications exhibited significantly higher levels of positive symptoms (SMD=0.10), general psychopathology (SMD=0.37), total clinical symptomatology (SMD=0.44), and depressive symptoms (SMD=0.47).
• There were no significant differences in negative symptomatology or overall functioning.

The results of this meta-analysis indicate a clear link between obstetric complications and more severe symptoms in schizophrenia spectrum disorders. Patients with a history of OCs showed greater severity in positive symptoms, depressive symptoms, and overall symptom severity compared to those without OCs, but there were no differences in negative symptoms or functional outcomes.

The findings highlight how issues during pregnancy and childbirth can affect the progression of schizophrenia, even in the early stages of the illness. However, due to the limited number of studies available, more research is needed to explore the specifics of stressful perinatal events, including their type and timing, to better understand their impact on individuals with psychosis.

"Recognizing early life complications could serve as a warning sign for future challenges, providing an opportunity to create tailored interventions that improve both clinical and functional outcomes for those affected," the researchers concluded.

Reference:

Forte, M. F., Oliva, V., De Prisco, M., Garriga, M., Bitanihirwe, B., Alameda, L., González-Segura, À., Vieta, E., Baeza, I., Parellada, E., Penadés, R., Ramos-Quiroga, J., Amoretti, S., Mezquida, G., & Garcia-Rizo, C. (2024). Obstetric complications and psychopathology in schizophrenia: A systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews, 167, 105913. https://doi.org/10.1016/j.neubiorev.2024.105913