Hostname: page-component-7c8c6479df-94d59 Total loading time: 0 Render date: 2024-03-29T01:18:16.425Z Has data issue: false hasContentIssue false

Both low birthweight and high birthweight are associated with cognitive impairment in persons with schizophrenia and their first-degree relatives

Published online by Cambridge University Press:  29 January 2013

M. Torniainen*
Affiliation:
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland Institute of Behavioral Sciences, University of Helsinki, Finland
A. Wegelius
Affiliation:
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland Department of Psychiatry, Helsinki University Central Hospital, Finland
A. Tuulio-Henriksson
Affiliation:
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland Institute of Behavioral Sciences, University of Helsinki, Finland Social Insurance Institution of Finland, Helsinki, Finland
J. Lönnqvist
Affiliation:
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland Institute of Behavioral Sciences, University of Helsinki, Finland Department of Psychiatry, University of Helsinki, Finland
J. Suvisaari
Affiliation:
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland Department of Social Psychiatry, Tampere School of Public Health, University of Tampere, Finland
*
*Address for correspondence: M. Torniainen, M.Psych., Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, PO Box 30, 00271 Helsinki, Finland. (Email: minna.torniainen@thl.fi)

Abstract

Background

Both low birthweight and high birthweight have been associated with an increased risk for schizophrenia and cognitive impairments in the general population. We assessed the association between birthweight and cognitive performance in persons with schizophrenia and their unaffected first-degree relatives.

Method

We investigated a population-based family sample comprising persons with schizophrenia (n = 142) and their unaffected first-degree relatives (n = 277). Both patients and relatives were interviewed with the Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-CV) and a comprehensive neuropsychological test battery was administered. Information on birthweight was obtained from obstetric records. We used generalized estimating equation (GEE) models to investigate the effect of birthweight, as a continuous variable, on cognitive functioning, adjusting for within-family correlation and relevant covariates.

Results

Both low birthweight and high birthweight were associated with lower performance in visuospatial reasoning, processing speed, set-shifting and verbal and visual working memory among persons with schizophrenia and their unaffected first-degree relatives compared to individuals with birthweight in the intermediate range. The group × birthweight interactions were non-significant.

Conclusions

Both low birthweight and high birthweight are associated with deficits in cognition later in life. Schizophrenia does not seem to modify the relationship between birthweight and cognition in families with schizophrenia.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aarnoudse-Moens, CS, Weisglas-Kuperus, N, van Goudoever, JB, Oosterlaa, J (2009). Meta-analysis of neurobehavioral outcomes in very preterm and/or very low birth weight children. Pediatrics 124, 717728.CrossRefGoogle ScholarPubMed
Abel, KM, Wicks, S, Susser, ES, Dalman, C, Pedersen, MG, Mortensen, PB, Webb, RT (2010). Birth weight, schizophrenia, and adult mental disorder: is risk confined to the smallest babies? Archives of General Psychiatry 67, 923930.CrossRefGoogle Scholar
Allin, MP, Kontis, D, Walshe, M, Wyatt, J, Barker, GJ, Kanaan, RA, McGuire, P, Rifkin, L, Murray, RM, Nosarti, C (2011). White matter and cognition in adults who were born preterm. PLoS One 6, e24525.CrossRefGoogle ScholarPubMed
APA (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn, text revision (DSM-IV-TR). American Psychiatric Association: Washington, DC.Google Scholar
Arajärvi, R, Haukka, J, Varilo, T, Suokas, J, Juvonen, H, Suvisaari, J, Muhonen, M, Suominen, K, Tuulio-Henriksson, A, Schreck, M, Hovatta, I, Partonen, T, Lönnqvist, J (2004). Clinical phenotype of schizophrenia in a Finnish isolate. Schizophrenia Research 67, 195205.CrossRefGoogle Scholar
Barker, DJ (1995). Fetal origins of coronary heart disease. British Medical Journal 311, 171174.CrossRefGoogle ScholarPubMed
Baron, IS, Litman, FR, Ahronovich, MD, Baker, R (2012). Late preterm birth: a review of medical and neuropsychological childhood outcomes. Neuropsychology Review 22, 438450.CrossRefGoogle ScholarPubMed
Cannon, M, Moffitt, TE, Caspi, A, Murray, RM, Harrington, H, Poulton, R (2006). Neuropsychological performance at the age of 13 years and adult schizophreniform disorder: prospective birth cohort study. British Journal of Psychiatry 189, 463464.CrossRefGoogle ScholarPubMed
Cannon, TD, van Erp, TG, Rosso, IM, Huttunen, M, Lönnqvist, J, Pirkola, T, Salonen, O, Valanne, L, Poutanen, VP, Standertskjold-Nordenstam, CG (2002). Fetal hypoxia and structural brain abnormalities in schizophrenic patients, their siblings, and controls. Archives of General Psychiatry 59, 3541.CrossRefGoogle ScholarPubMed
Cohen, J (1988). Power Analysis for the Behavioral Sciences, 2nd edn. Lawrence Erlbaum Associates: Hillsdale, NJ.Google Scholar
Delis, DC, Kramer, JH, Kaplan, E, Ober, BA (1987). California Verbal Learning Test: Manual. Research Edition. The Psychological Corporation/Harcourt Brace & Company: San Antonio, TX.Google Scholar
Dickinson, D, Ramsey, ME, Gold, JM (2007). Overlooking the obvious: a meta-analytic comparison of digit symbol coding tasks and other cognitive measures in schizophrenia. Archives of General Psychiatry 64, 532542.CrossRefGoogle ScholarPubMed
First, MB, Spitzer, RL, Gibbon, M, Williams, JBW (1996). Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-CV). American Psychiatric Press, Inc., Washington, DC.Google Scholar
Fowden, AL, Giussani, DA, Forhead, AJ (2006). Intrauterine programming of physiological systems: causes and consequences. Physiology (Bethesda) 21, 2937.Google ScholarPubMed
Freedman, D, Bao, Y, Kremen, WS, Vinogradov, S, McKeague, IW, Brown, AS (2012). Birth weight and neurocognition in schizophrenia spectrum disorders. Schizophrenia Bulletin. Published online: 29 February 2012. doi: 10.1093/schbul/sbs008.Google ScholarPubMed
Golden, C (1978). Stroop Color and Word Test: Manual for Clinical and Experimental Uses. Stoelting: Chicago, IL.Google Scholar
Gunnell, D, Rasmussen, F, Fouskakis, D, Tynelius, P, Harrison, G (2003). Patterns of fetal and childhood growth and the development of psychosis in young males: a cohort study. American Journal of Epidemiology 158, 291300.CrossRefGoogle ScholarPubMed
Henriksen, T (2008). The macrosomic fetus: a challenge in current obstetrics. Acta Obstetricia et Gynecologica Scandinavica 87, 134145.CrossRefGoogle ScholarPubMed
Hoti, F, Tuulio-Henriksson, A, Haukka, J, Partonen, T, Holmström, L, Lönnqvist, J (2004). Family-based clusters of cognitive test performance in familial schizophrenia. BioMed Central Psychiatry 4, 20.CrossRefGoogle ScholarPubMed
Hovatta, I, Terwilliger, JD, Lichtermann, D, Mäkikyrö, T, Suvisaari, J, Peltonen, L, Lönnqvist, J (1997). Schizophrenia in the genetic isolate of Finland. American Journal of Medical Genetics 74, 353360.3.0.CO;2-Q>CrossRefGoogle ScholarPubMed
Jolly, MC, Sebire, NJ, Harris, JP, Regan, L, Robinson, S (2003). Risk factors for macrosomia and its clinical consequences: a study of 350,311 pregnancies. European Journal of Obstetrics, Gynecology, and Reproductive Biology 111, 914.CrossRefGoogle Scholar
Karilampi, U, Helldin, L, Archer, T (2011). Cognition and global assessment of functioning in male and female outpatients with schizophrenia spectrum disorders. Journal of Nervous and Mental Disease 199, 445448.CrossRefGoogle ScholarPubMed
Kelleher, I, Clarke, MC, Rawdon, C, Murphy, J, Cannon, M (2012). Neurocognition in the extended psychosis phenotype: performance of a community sample of adolescents with psychotic symptoms on the MATRICS neurocognitive battery. Schizophrenia Bulletin. Published online: 4 September 2012. doi: 10.1093/schbul/sbs086.Google ScholarPubMed
Kirkegaard, I, Obel, C, Hedegaard, M, Henriksen, TB (2006). Gestational age and birth weight in relation to school performance of 10-year-old children: a follow-up study of children born after 32 completed weeks. Pediatrics 118, 16001606.CrossRefGoogle ScholarPubMed
Koskela, O (1965). Large fetus; a geographic modification. Annales Chirurgiae et Gynaecologiae Fenniae 54, 461471.Google ScholarPubMed
Leonard, H, Nassar, N, Bourke, J, Blair, E, Mulroy, S, de Klerk, N, Bower, C (2008). Relation between intrauterine growth and subsequent intellectual disability in a ten-year population cohort of children in Western Australia. American Journal of Epidemiology 167, 103111.CrossRefGoogle Scholar
MacLeod, CM (1991). Half a century of research on the Stroop effect: an integrative review. Psychological Bulletin 109, 163203.CrossRefGoogle ScholarPubMed
Morgan, VA, Croft, ML, Valuri, GM, Zubrick, SR, Bower, C, McNeil, TF, Jablensky, AV (2012). Intellectual disability and other neuropsychiatric outcomes in high-risk children of mothers with schizophrenia, bipolar disorder and unipolar major depression. British Journal of Psychiatry 200, 282289.CrossRefGoogle ScholarPubMed
Morgane, PJ, Austin-LaFrance, R, Bronzino, J, Tonkiss, J, Diaz-Cintra, S, Cintra, L, Kemper, T, Galler, JR (1993). Prenatal malnutrition and development of the brain. Neuroscience and Biobehavioral Reviews 17, 91128.CrossRefGoogle ScholarPubMed
Reichenberg, A, Harvey, PD (2007). Neuropsychological impairments in schizophrenia: integration of performance-based and brain imaging findings. Psychological Bulletin 133, 833858.CrossRefGoogle ScholarPubMed
Reitan, RM, Wolfson, D (1985). The Halstead Reitan Neuropsychological Test Battery. Neuropsychology Press: Tuscon, AZ.Google Scholar
Rifkin, L, Lewis, S, Jones, P, Toone, B, Murray, R (1994). Low birth weight and schizophrenia. British Journal of Psychiatry 165, 357362.CrossRefGoogle ScholarPubMed
Shenkin, SD, Starr, JM, Deary, IJ (2004). Birth weight and cognitive ability in childhood: a systematic review. Psychological Bulletin 130, 9891013.CrossRefGoogle ScholarPubMed
Silva, A, Metha, Z, O'Callaghan, FJ (2006). The relative effect of size at birth, postnatal growth and social factors on cognitive function in late childhood. Annals of Epidemiology 16, 469476.CrossRefGoogle ScholarPubMed
Sitskoorn, MM, Aleman, A, Ebisch, SJ, Appels, MC, Kahn, RS (2004). Cognitive deficits in relatives of patients with schizophrenia: a meta-analysis. Schizophrenia Research 71, 285295.CrossRefGoogle ScholarPubMed
Skranes, J, Vangberg, TR, Kulseng, S, Indredavik, MS, Evensen, KA, Martinussen, M, Dale, AM, Haraldseth, O, Brubakk, AM (2007). Clinical findings and white matter abnormalities seen on diffusion tensor imaging in adolescents with very low birth weight. Brain 130, 654666.CrossRefGoogle ScholarPubMed
Sorensen, HJ, Mortensen, EL, Reinisch, JM, Mednick, SA (2006). Height, weight and body mass index in early adulthood and risk of schizophrenia. Acta Psychiatrica Scandinavica 114, 4954.CrossRefGoogle ScholarPubMed
Tanskanen, P, Valkama, M, Haapea, M, Barnes, A, Ridler, K, Miettunen, J, Murray, GK, Veijola, JM, Jones, PB, Taanila, AM, Isohanni, MK (2011). Is prematurity associated with adult cognitive outcome and brain structure? Pediatric Neurology 44, 1220.CrossRefGoogle ScholarPubMed
Torniainen, M, Suvisaari, J, Partonen, T, Castaneda, AE, Kuha, A, Perälä, J, Saarni, S, Lönnqvist, J, Tuulio-Henriksson, A (2011). Sex differences in cognition among persons with schizophrenia and healthy first-degree relatives. Psychiatry Research 188, 712.CrossRefGoogle ScholarPubMed
Turken, A, Whitfield-Gabrieli, S, Bammer, R, Baldo, JV, Dronkers, NF, Gabrieli, JD (2008). Cognitive processing speed and the structure of white matter pathways: convergent evidence from normal variation and lesion studies. NeuroImage 42, 10321044.CrossRefGoogle ScholarPubMed
Tuulio-Henriksson, A, Arajärvi, R, Partonen, T, Haukka, J, Varilo, T, Schreck, M, Cannon, T, Lönnqvist, J (2003). Familial loading associates with impairment in visual span among healthy siblings of schizophrenia patients. Biological Psychiatry 54, 623628.CrossRefGoogle ScholarPubMed
Van Lieshout, RJ, Boyle, MH (2011). Is bigger better? Macrosomia and psychopathology later in life. Obesity Reviews 12, e405e411.CrossRefGoogle ScholarPubMed
Van Lieshout, RJ, Voruganti, LP (2008). Diabetes mellitus during pregnancy and increased risk of schizophrenia in offspring: a review of the evidence and putative mechanisms. Journal of Psychiatry and Neuroscience 33, 395404.Google ScholarPubMed
Videman, T, Heikkilä, J (1978). Frequent users of doctor services in a small rural community. Scandinavian Journal of Social Medicine 6, 3741.CrossRefGoogle Scholar
Volpe, JJ (2009). Brain injury in premature infants: a complex amalgam of destructive and developmental disturbances. Lancet Neurology 8, 110124.CrossRefGoogle ScholarPubMed
Wechsler, D (1981). WAIS-R: Manual: Wechsler Adult Intelligence Scale – Revised. The Psychological Corporation: Cleveland, OH.Google Scholar
Wechsler, D (1987). WMS-R: Wechsler Memory Scale – Revised, Manual. The Psychological Corporation: San Antonio, TX.Google Scholar
Wegelius, A, Tuulio-Henriksson, A, Pankakoski, M, Haukka, J, Lehto, U, Paunio, T, Lönnqvist, J, Suvisaari, J (2011). An association between high birth weight and schizophrenia in a Finnish schizophrenia family study sample. Psychiatry Research 190, 181186.CrossRefGoogle Scholar
Zeger, SL, Liang, KY (1986). Longitudinal data analysis for discrete and continuous outcomes. Biometrics 42, 121130.CrossRefGoogle ScholarPubMed
Supplementary material: PDF

Torniainen Supplementary Material

Appendix

Download Torniainen Supplementary Material(PDF)
PDF 110.8 KB