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Association of Schizophrenia With Low Maternal Body Mass Index, Small Size at Birth, and Thinness During Childhood
Kristian Wahlbeck, MD, MScD;
Tom Forsén, MD, MScD;
Clive Osmond, PhD;
David J. P. Barker, FRS;
Johan G. Eriksson, MD, MScD
Arch Gen Psychiatry. 2001;58:48-52.
Background Nutritional factors in early life may contribute to the neurodevelopmental
deficit in schizophrenia. This study explores the influence of maternal body
size, size at birth, and childhood growth on future risk for schizophrenia.
Subjects and Methods This population-based cohort study comprised births at Helsinki University
Central Hospital in Helsinki, Finland, from 1924 to 1933. Prospective data
from birth and school health records of 7086 individuals were collected and
linked to the Finnish Hospital Discharge Register.
Results Schizophrenia or schizoaffective disorder had been diagnosed in 114
individuals. A lower late-pregnancy maternal body mass index (BMI) increased
the risk (odds ratio [OR], 1.09 per kilogram/meter2; 95% confidence
interval [CI], 1.02-1.17) for schizophrenia among the offspring. The risk
of schizophrenia increased with low birth weight (OR, 1.48 per kilogram; 95%
CI, 1.03-2.13), shortness at birth (OR, 1.12 per centimeter; 95% CI, 1.03-1.22),
and low placental weight (OR, 1.22 per 100 g; 95% CI, 1.04-1.43). Schizophrenia
cases were thinner than comparison subjects from 7 to 15 years of age. In
a joint model comprising late-pregnancy maternal BMI, body size at birth,
and childhood BMI, childhood BMI was an independent predictor of schizophrenia,
whereas other factors exhibited attenuated effects.
Conclusion Indicators of intrauterine and childhood undernutrition are associated
with an increased lifetime risk of schizophrenia.
From the Department of Psychiatry, University of Helsinki (Dr Wahlbeck),
and the National Public Health Institute (Drs Forsén and Eriksson),
Helsinki, Finland; and the Medical Research Council Environmental Epidemiology
Unit, University of Southampton, Southampton, England (Drs Osmond and Barker).
Corresponding author: Kristian Wahlbeck, MD, MScD, Department of
Psychiatry, University of Helsinki, Lappviksvägen, PO Box 320, FIN-00029,
Helsinki, Finland (e-mail: kristian.wahlbeck{at}helsinki.fi).
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