Preterm birth increases psychiatric disorder risk

By Mark Cowen

Individuals born preterm are at increased risk for a range of psychiatric disorders in young adulthood, researchers report.

Furthermore, this risk increases with younger gestational age, say Chiara Nosarti (King's College London, UK) and team.

The findings come from a study of 1,301,522 individuals from the Swedish Medical Birth Register who were born between 1973 and 1985.

Data on gestational age were compared with information on hospital admissions for psychiatric disorders at a mean follow-up age of 23 years.

The researchers found that individuals born preterm at 32-36 weeks' gestation were 1.6, 1.3, and 2.7 times more likely to have been hospitalized for nonaffective psychosis, depressive disorder, and bipolar affective disorder, respectively, in young adulthood (≥16 years of age) than those born at term (37-41 weeks).

In addition, individuals born at less than 32 weeks' gestation were a respective 2.5, 2.9, and 7.4 times more likely to have been hospitalized for nonaffective psychosis, depressive disorder, and bipolar affective disorder in young adulthood than those born at term.

Individuals born preterm also had a significantly increased risk for eating disorders and drug and alcohol dependency compared with those born at term.

The findings remained true after accounting for gender, maternal age at delivery, maternal education, family history of psychiatric disorders, and other variables.

And the associations persisted after adjustment for other pregnancy outcomes previously associated with an increased risk for psychiatric disorders, such as nonoptimal fetal growth and low Apgar score.

Nosarti and team conclude in the Archives of General Psychiatry: "The finding of a significant monotonic association between gestational age and later hospital admission with a range of psychiatric diagnoses suggests that future longitudinal research combining gene-environment information, including gestational age, may represent a useful investigative tool with potential for early identification of individuals who may be particularly vulnerable to develop a variety of psychiatric disorders in late adolescence and young adulthood."

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