title: Psychiatric morbidity is related to a chain of prenatal and perinatal adversities.
abstract: BACKGROUND
  Most studies on the effects of early risk factors on future mental health focus on specific obstetric complications as risk factors for specific disorders. However, obstetric complications rarely occur in isolation, and the same holds for psychiatric problems.
  
  
  OBJECTIVE
  To study prenatal and perinatal risk factors for psychiatric multimorbidity in early adulthood and to determine whether these differ from risk factors for monomorbidity.
  
  
  METHODS
  Monomorbidity and multimorbidity of six types of psychiatric disorders were determined by a standardised psychiatric interview. Using univariate and multivariate logistic and ordinal logistic regression, associations of mono- and multimorbidity with prospectively collected early risk factors were examined.
  
  
  METHODS
  Two hundred and eighty-five young adults selected from a prospective birth cohort on the basis of their Obstetric Optimality Scores.
  
  
  METHODS
  Six types of psychiatric disorder and their co-occurrence.
  
  
  RESULTS
  Monomorbidity was related to isolated early risk factors such as low birth weight or a low Apgar score, and to an accumulation of unfavourable pre- and perinatal events. Multimorbidity on the other hand, was only related to a chain of pre- and perinatal adversities.
  
  
  CONCLUSIONS
  Research and prevention strategies should not focus solely on isolated early risk factors, but also on the entire pre- and perinatal situation.
authors.affiliation: Accare University Centre Child Psychiatry, Hanzeplein 1, PO Box 660, 9700 AR Groningen, The Netherlands. l.batstra@accare.nl
authors.forename: L
authors.initials: L
authors.lastname: Batstra
authors.forename: J
authors.initials: J
authors.lastname: Neeleman
authors.forename: C
authors.initials: C
authors.lastname: Elsinga
authors.forename: M
authors.initials: M
authors.lastname: Hadders-Algra
mesh_terms: D000328:Adult; D001034:Apgar Score; D001724:Birth Weight; D001942:Breast Feeding; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D017533:Marital Status; D001523:Mental Disorders / Q000453:epidemiology* / Q000209:etiology*; D015999:Multivariate Analysis; D009426:Netherlands / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D012923:Social Class