OBSTETRIC COMPLICATIONS AND AGE AT ONSET IN SCHIZOPHRENIA - AN INTERNATIONAL COLLABORATIVE METAANALYSIS OF INDIVIDUAL PATIENT DATA

Objective: An excess of obstetric complications in the histories of sc hizophrenic patients is a well-replicated finding, but less consistent results have been found concerning the relationships between obstetri c complications and family history of schizophrenia, age at onset of l imited the power of previous studies that attempted to assess such rel ationships. The aim of this study was to rise data on individual Patie nts from all available studies to examine the links between a history of obstetric complications and family history of schizophrenia , age a t onset, and gender. Method: Raw data from 854 schizophrenic patients concerning history of obstetric complications rated according to the L ewis and Murray scale were obtained from 11 different research groups. Weighted average estimates were calculated with the use of regression techniques. Results: A significant association was found between age at onset of schizophrenia and obstetric complications: the earlier the age at onset, the more likely the history of obstetric complications. Subjects with onset of schizophrenia before age 22 were 2.7 times mor e likely than those with onset at a later age to have had a history of abnormal presentation at birth and 10 times more likely to have had a history of complicated Cesarean birth. No association was found betwe en obstetric complications and family history of schizophrenia or gend er. Conclusions: The association between obstetrics complications and early age at onset of schizophrenia indicates that the pathophysiology oi early-onset schizophrenia involves neurodevelopmental impairment.