Examining the association between prenatal and perinatal adversity and the psychotic experiences in childhood

Lorna Staines; Niamh Dooley; Colm Healy; Ian Kelleher; David Cotter; Mary Cannon

doi:10.1017/S0033291724000187

Examining the association between prenatal and perinatal adversity and the psychotic experiences in childhood

Psychol Med. 2024 Mar 4:1-12. doi: 10.1017/S0033291724000187. Online ahead of print.

Authors

Lorna Staines¹, Niamh Dooley¹, Colm Healy¹, Ian Kelleher^{1

2}, David Cotter^{1

3}, Mary Cannon^{1

3}

Affiliations

¹ Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland.
² Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh EH10 5HF, UK.
³ Department of Psychiatry, Beaumont Hospital, Dublin 9, Ireland.

PMID: 38433592
DOI: 10.1017/S0033291724000187

Abstract

Background: Prenatal and perinatal complications are established risk factors for psychotic disorder, but far less is known about these measures and psychotic experiences (PEs). We investigated the longitudinal effect of prenatal risk factors (maternal behavior, medication complications) and perinatal risk factors (birth weight, medical complications) on frequency of PEs. We also examined the cumulative risk of prenatal/perinatal risk factors, and differences between transient PE, persistent PE, and controls.

Methods: The Adolescent Brain Cognitive Development study is a large child cohort (age 9-10 at baseline; n = 11 872 with PE data). PEs were measured longitudinally using the Prodromal Questionnaire-Brief, Child version, and included only if reported as distressing. Mixed-effects models were used for analysis, controlling for random effects, and a substantial number of fixed-effects covariates.

Results: Urinary tract infection (β = 0.11, 95% confidence interval [CI] 0.03-0.19) and severe anemia (β = 0.18, 95% CI 0.07-0.29) increased frequency of distressing PEs in childhood. Number of prenatal complications increased frequency of PEs (β = 0.03, 95% CI 0.01-0.06) and risk of persistent PEs (odds ratio [OR] = 1.08, 95% CI 1.01-1.15). Maternal smoking was associated with an increased frequency of PEs (β = 0.11, 95% CI 0.04-0.18) and persistent PEs (OR = 1.31, 95% CI 1.04-1.66). Maternal substance use was a risk factor for a 48% increased risk of persistent PEs (OR = 1.48, 95% CI 1.08-2.01). Perinatal complications showed no effect on PEs.

Conclusions: This study provides evidence that certain prenatal medical complications (severe nausea, severe anemia), cumulative number of prenatal medical complications, and maternal behaviors (smoking during pregnancy), increased frequency of distressing PEs in childhood. Maternal smoking and substance use, as well as cumulative number of prenatal complications increased risk of persistent PEs.

Keywords: persistent psychotic experiences; prenatal complications; psychosis; psychotic experiences.

Abstract

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