Exposure to obstetric complications in relation to subsequent psychiatric disorders of adolescent inpatients: specific focus on gender differences.
BACKGROUND
Exposure to obstetric complications is known to be associated with subsequent development of psychiatric disorders. However, earlier findings are mainly based on adult populations having a long follow-up time for onset of psychiatric illness. We examined whether the association of obstetric complications with severe mental disorders is already seen in a population of underage adolescents admitted to psychiatric inpatient care.


METHODS
The study population was a clinical sample of adolescents (n = 508) aged 12-17 years admitted to psychiatric hospital. DSM-IV diagnoses of the psychiatric disorders of the adolescents as well as information on obstetric (i.e., pregnancy, delivery and perinatal) complications and substance use during pregnancy reported by the mothers of the adolescents were based on the semi-structured Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime.


RESULTS
A total of 96 (19%) adolescents had been exposed to obstetric complications. The prevalence of pregnancy, delivery or perinatal complications reported by the mothers of the offspring was 55 (57%), 57 (59%) and 13 (14%), respectively. Among adolescents with conduct disorder, exposure to delivery complications was more common among males compared to females (16 vs. 5%, p = 0.006); this was particularly true for section delivery (7 vs. 1%, p = 0.023). A trend towards a significant gender difference was also found among adolescents with anxiety disorder (21 vs. 8%, p = 0.085).


CONCLUSIONS
Boys seem to be more vulnerable to the exposure of delivery complications than girls. Exposure to obstetric complication may be associated with development of subsequent psychiatric disorder; particularly conduct disorder of adolescent boys.
Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Oulu, Finland.
Sari
S
Lukkari
Helinä
H
Hakko
Anne
A
Herva
Anneli
A
Pouta
Kaisa
K
Riala
Pirkko
P
Räsänen
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006778:Hospitals, Psychiatric; D006801:Humans; D007297:Inpatients; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D007744:Obstetric Labor Complications / Q000453:epidemiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011297:Prenatal Exposure Delayed Effects / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012727:Sex Characteristics