Background. Understanding the role of obstetric complications (OCs) in schi
zophrenia could potentially shed light on the heterogeneity in the aetiolog
y and course of schizophrenia. Many investigators have reported an associat
ion between OCs and schizophrenia, but few have examined the association be
tween OCs and treatment outcome. We investigated this question in a sample
of patients studied during their first episode of schizophrenia, schizoaffe
ctive or schizophreniform disorder.
Method. OC histories were obtained for 59 patients participating in the Hil
lside First Episode Study. Cox proportional hazards regression analysis was
used to estimate the effect of OCs on treatment response during the first
episode of schizophrenia.
Results. Twelve of the 59 patients (20 %) had positive histories of OCs. Th
is group exhibited lower rates of treatment response than those with negati
ve OC histories (hazard ratio controlling for sex = 0.28; 95 % CI = 0.13, 0
.62). The positive OC group also had significantly greater lateral ventricl
e volume, baseline disorganization and number of live births. The effect of
OC history on treatment response held when these three variables were cont
rolled for.
Conclusion. A history of obstetric complications predicted poor response to
treatment in the first episode of schizophrenia. This large effect was bas
ed on a small sample of 59 patients. Thus, replication is called for.