Are obstetrical, perinatal, and infantile difficulties associated with pediatric bipolar disorder?
OBJECTIVE
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.
Massachusetts General Hospital, Pediatric Psychopharmacology Unit, Boston, MA, USA.
Marykate
M
Martelon
Timothy E
TE
Wilens
Jesse P
JP
Anderson
Nicholas R
NR
Morrison
Janet
J
Wozniak
D000293:Adolescent; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000453:epidemiology; D001714:Bipolar Disorder / Q000453:epidemiology* / Q000235:genetics; D016022:Case-Control Studies; D002648:Child; D003085:Colic / Q000453:epidemiology; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D007744:Obstetric Labor Complications / Q000453:epidemiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D012307:Risk Factors; D035781:Siblings / Q000523:psychology*