At issue: The problem of obstetrical complications and schizophrenia

The use of the term "obstetrical complications" (OCs) and its variations to encompass diverse physiological mechanisms (e.g., genetic, ischemic, hemor rhagic, infectious) of disruption to fetal/neonatal brain development has e ngendered inconsistency, confusion, and controversy. The principal reason i s that the term OCs belies the absence of a fully adequate conceptual frame work for characterizing neurodevelopmental risk. We propose that neurodevel opmental risk factors for schizophrenia can be assessed more clearly if bro ad OC scales are replaced by measures representing more homogeneous pathway s of disturbed brain development. Using a new OC classification, me found t hat disordered growth related to hypoxic-ischemic compromise to early brain development may confer an elevated risk of schizophrenia and other adult-o nset psychoses, particularly in the presence of familial risk. Abnormal fet al and neonatal brain growth and development in schizophrenia and OCs may a lso, at least in part, result from genetic factors and could help explain t he relation between seemingly inconsistent OCs identified in prior research .