Are obstetrical, perinatal, and infantile difficulties associated with pediatric bipolar disorder?

Bipolar Disord. 2012 Aug;14(5):507-14. doi: 10.1111/j.1399-5618.2012.01027.x. Epub 2012 May 29.

Abstract

Objectives: Despite increasing acknowledgement of bipolar disorder (BD) in childhood, there is a paucity of literature that has investigated obstetrical, perinatal, and infantile difficulties and their potential link with BD. To this end, we examined difficulties during delivery, immediate post-birth, and infancy and the association with BD in childhood.

Methods: From two similarly designed, ongoing, longitudinal, case-control family studies of pediatric BD (N = 327 families), we analyzed 338 children and adolescents [mean (± standard deviation) age: 12.00 ± 3.37 years]. We stratified them into three groups: healthy controls (N = 98), BD probands (N = 120), and their non-affected siblings (N = 120). All families were comprehensively assessed with a structured psychiatric diagnostic interview for psychopathology and substance use. Mothers were directly questioned regarding the pregnancy, delivery, and infancy difficulties that occurred with each child using a module from the Diagnostic Interview for Children and Adolescents-Parent Version (DICA-P).

Results: Mothers of BD subjects were more likely to report difficulties during infancy than mothers of controls [odds ratio (95% confidence interval) = 6.6 (3.0, 14.6)]. Specifically, children with BD were more likely to have been reported as a stiffened infant [7.2 (1.1, 47.1)] and more likely to have experienced 'other' infantile difficulties [including acting colicky; 4.9 (1.3, 18.8)] compared to controls. We found no significant differences between groups in regards to obstetrical or perinatal difficulties (all p values > 0.05).

Conclusions: While our results add to previous literature on obstetrical and perinatal difficulties and BD, they also highlight characteristics in infancy that may be prognostic indicators for pediatric BD.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Attention Deficit and Disruptive Behavior Disorders / epidemiology
  • Bipolar Disorder / epidemiology*
  • Bipolar Disorder / genetics
  • Case-Control Studies
  • Child
  • Colic / epidemiology
  • Female
  • Genetic Predisposition to Disease
  • Humans
  • Infant
  • Longitudinal Studies
  • Male
  • Obstetric Labor Complications / epidemiology*
  • Pregnancy
  • Pregnancy Complications / epidemiology*
  • Risk Factors
  • Siblings / psychology*