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Key processes in human neurodevelopment take place within the biological environment of pregnancy and birth. Insults within this biological context can have long-term consequences on brain function, ranging from learning disabilities to complex psychiatric disorders such as schizophrenia. Birth asphyxia is the failure to start regular respiration within a minute of birth and is a neonatal emergency that may cause hypoxia (insufficient supply of oxygen to the brain and tissues) and possible brain damage or death, if left untreated. The perinatal period is associated with high risks and represents one of the first developmental milestones of brain development. During childbirth, there are cellular processes in place that increase the resistance of neurons to hypoxia and ischemic damage. These cellular processes are resilience factors that should protect against hypoxic insult. Previous reports have found alterations in genes regulated by hypoxia in schizophrenia and the lack of hypoxia related resilience factors in the presence of birth asphyxia might increase the risk for schizophrenia development. Therapeutic interventions for birth asphyxia, typically before the onset of clear neurological and behavioral symptoms, might prevent or ameliorate the development of schizophrenia later in life.
W0064 - Obstetric Complications: The Forgotten Risk Factor for Schizophrenia
W0065 - Birth Asphyxia and Its Implications for Neuropsychology and Brain Volume in Schizophrenia
Introduction. Newborn infants can suffer permanent brain damage as a result of birth asphyxia (ASP), a severe obstetric complication (OC). However, effects of OCs on cognitive abilities and brain structure in schizophrenia (SZ) are unknown.
Objectives. The main goals of this study were to investigate putative effects of a history of OCs on adult cognition and brain structure in SZ.
Methods. We utilized prospective data from the Medical Birth Registry of Norway to identify incidences of severe OCs in adult healthy controls (HC; n = 622) and patients with SZ (n = 607). IQ was assessed, and a subset of participants (n= 414) underwent magnetic resonance imaging.
Results. Severe OCs (27%) and ASP (14%) were equally common in SZ and HC. SZ patients with OCs had lower IQ than patients without OCs, a difference not found in HC (p = .023). Having experienced more than one co-occurring severe OC was associated with lower IQ in both groups, wherein 81% of co-occurring OCs involved ASP. ASP was related to smaller intracranial volume and brain volumes in both groups. Smaller caudate volumes were found in SZ patients with ASP compared to patients without ASP, a difference not found in HC (p = .009).
Conclusions. Our findings give support for an effect of birth ASP on brain development in both patients with SZ and HC. OC history specifically impacts IQ in SZ. Smaller caudate volumes might be particularly related to disease development. These results warrant replication in an independent sample.