Social Psychiatry and Psychiatric Epidemiology

, Volume 41, Issue 8, pp 605–610 | Cite as

Does unwantedness of pregnancy predict schizophrenia in the offspring?

Findings from a prospective birth cohort study
  • Daniel B. Herman
  • Alan S. Brown
  • Mark G. Opler
  • Manisha Desai
  • Dolores Malaspina
  • Michaeline Bresnahan
  • Catherine A. Schaefer
  • Ezra S. Susser
ORIGINAL PAPER

Abstract

Background

We sought to replicate (or refute) a previous report of an association between unwantedness of a pregnancy and the risk of schizophrenia in the offspring.

Method

The study was conducted using a large, prospectively collected birth cohort as part of the Prenatal Determinants of Schizophrenia study (PDS). Attitude toward the pregnancy was assessed at the time of the mother’s first visit to the prenatal clinic. Cases of schizophrenia and other schizophrenia spectrum disorders in the offspring of these mothers were subsequently ascertained and diagnosed. In univariate and multivariate analyses, we examined the relationship between attitude toward the pregnancy and risk of adult schizophrenia and other schizophrenia spectrum disorders.

Results

The unadjusted hazard ratio for the association between ambivalent or negative maternal attitude toward the pregnancy and the risk of schizophrenia spectrum disorders was 1.75, (95% CI = 0.97, 3.17, = 0.06). This result was unchanged after adjustment for social class, paternal age, race/ethnicity and other potential confounders. Similar results were observed when only cases with schizophrenia were included in the analysis.

Conclusions

We did not find a statistically significant association in favor of the hypothesis that unwantedness of pregnancy is a risk factor for adult schizophrenia. On the other hand, the magnitude of the observed association was similar to the findings of the only previous study of this question and the confidence limits overlap those findings. Whether unwantedness of pregnancy is a risk factor for adult schizophrenia remains an open question that may be resolved by future research.

Key words

cohort studies etiology pregnancy risk factors schizophrenia stress 

References

  1. 1.
    Abma JCA, Mosher W, Peterson L, Piccinino L (1997) Fertility, family planning, and women’s health: new data from the 1995 National Survey of Family Growth. National Center for Hesalth Statistics. Vital Health Stat Series No. 23 (19)Google Scholar
  2. 2.
    Bustan M, Coker A (1994) Maternal attitude toward pregnancy and the risk of neonatal death. Am J Pub Hlth 84:411–414Google Scholar
  3. 3.
    Laukaran V, Berg BVD (1980) The relationship of maternal attitude to pregnacy outcomes and obstetric complications: a cohort study of unwanted pregnancy. Am J Obstet Gynecol 136:278–279Google Scholar
  4. 4.
    Sable M, Spencer J, Stockbauer J, Schramm W, Howell V, Herman A (1997) Pregnancy wantedness and adverse pregnancy outcomes: differences by race and Medicaid status. Family Planning Perspect 29:77–81Google Scholar
  5. 5.
    Myhrman A, Olsen P, Rantakillio P, Laara E (1995) Does the wantedness of a pregnancy predict a child’s educational attainment? Family Planning Perspectives 27:116–119PubMedCrossRefGoogle Scholar
  6. 6.
    Rasanen P, Hakko H, Isohanni M, Hodgins S, Jarvelin M-R, Tiihonen J (1999) Maternal smoking during pregnancy and risk of criminal behavior among adult male offspring in the northern finland 1966 Birth Cohort. Am J Psychiatry 156:857–862PubMedGoogle Scholar
  7. 7.
    Kubicka L, Matejcek Z, David HP, Dytrych Z, Miller WB, Roth Z (1995) Children from unwanted pregnancies in Prague, Czech Republic revisited at age thirty. Acta Psychiatr Scand 91:361–369PubMedGoogle Scholar
  8. 8.
    Kubicka L, Roth Z, Dytrych Z, Matejcek Z, David HP (2002) The mental health of adults born of unwanted pregnancies, their siblings, and matched controls: a 35-year follow-up study from Prague, Czech Republic. J Nerv Ment Dis 190:653–662PubMedCrossRefGoogle Scholar
  9. 9.
    Joyce T, Kaestner R, Korenman S (2000) The effect of pregnancy intention on child development. Demography 37:83–94PubMedGoogle Scholar
  10. 10.
    Myhrman A, Rantakallio P, Isohanni M, Jones P, Partanen U (1996) Unwantedness of pregnancy and schizophrenia in the child. Br J Psychiatry 169:637–640PubMedCrossRefGoogle Scholar
  11. 11.
    Cannon M, Jones PB, Murray RM (2002) Obstetric complications and schizophrenia: historical and meta-analytic review. Am J Psychiatry 159:1080–1092PubMedCrossRefGoogle Scholar
  12. 12.
    Cicchetti D, Walker E (2003) Neurodevelopmental mechanisms in psychopathology. Cambridge University Press, CambridgeGoogle Scholar
  13. 13.
    Susser ES, Schaefer CA, Brown AS, Begg MD, Wyatt RJ (2000) The design of the prenatal determinants of schizophrenia study. Schizophr Bull 26:257–273PubMedGoogle Scholar
  14. 14.
    van den Berg B (1984) The California Child Health and Development Studies. In: Mednick S, Harway M. Finello K (eds) Handbook of Longitudinal Research. Praeger, New York, pp 166–179Google Scholar
  15. 15.
    Kendler KS, Walsh D (1995) Schizotypal personality disorder in parents and the risk for schizophrenia in siblings. Schizophr Bull 21:47–52PubMedGoogle Scholar
  16. 16.
    Nurnberger JI Jr, Blehar MC, Kaufmann CA, York-Cooler C, Simpson SG, Harkavy-Friedman J, Severe JB, Malaspina D, Reich T (1994) Diagnostic interview for genetic studies. Rationale, unique features, and training. NIMH Genetics Initiative. Arch Gen Psychiatry 51:849–859 (discussion 863–844)PubMedGoogle Scholar
  17. 17.
    Brown AS, Schaefer CA, Wyatt RJ, Begg MD, Goetz R, Bresnahan MA, Harkavy-Friedman J, Gorman JM, Malaspina D, Susser ES (2002) Paternal age and risk of schizophrenia in adult offspring. Am J Psychiatry 159:1528–1533PubMedCrossRefGoogle Scholar
  18. 18.
    Huttunen MO, Niskanen P (1973) Prenatal loss of father and psychiatric disorders. Arch Gen Psychiatry 35:429–431Google Scholar
  19. 19.
    van Os J, Selten J (1998) Prenatal exposure to maternal stress and subsequent schizophrenia. The May 1940 invasion of The Netherlands. Br J Psychiatry 172:324–326PubMedGoogle Scholar
  20. 20.
    Kinney D, Hyman W, Greetham C, Tramer S (1999) Increased relative risk for schizophrenia and prenatal exposure to a severe tornado. Schizophr Res 13:45–46Google Scholar
  21. 21.
    Koenig JI, Kirkpatrick B, Lee P (2002) Glucocorticoid hormones and early brain development in schizophrenia. Neuropsychopharmacology 27:309–318PubMedCrossRefGoogle Scholar

Copyright information

© Steinkopff Verlag Darmstadt 2006

Authors and Affiliations

  • Daniel B. Herman
    • 1
    • 2
  • Alan S. Brown
    • 1
    • 3
  • Mark G. Opler
    • 2
  • Manisha Desai
    • 2
  • Dolores Malaspina
    • 1
    • 3
  • Michaeline Bresnahan
    • 1
    • 2
  • Catherine A. Schaefer
    • 4
  • Ezra S. Susser
    • 1
    • 2
  1. 1.New York State Psychiatric InstituteNew YorkUSA
  2. 2.Dept. of EpidemiologyColumbia University, Mailman School of Public HealthNew YorkUSA
  3. 3.College of Physicians and SurgeonsColumbia UniversityNew YorkUSA
  4. 4.Division of ResearchKaiser PermanenteOaklandUSA

Personalised recommendations