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Obstetric complications and cognition in schizophrenia: a systematic review and meta-analysis

Published online by Cambridge University Press:  18 August 2022

Silvia Amoretti Open the ORCID record for Silvia Amoretti [Opens in a new window] ,
Francisco Diego Rabelo-da-Ponte Open the ORCID record for Francisco Diego Rabelo-da-Ponte [Opens in a new window] ,
Marina Garriga Open the ORCID record for Marina Garriga [Opens in a new window] ,
Maria Florencia Forte ,
Rafael Penadés Open the ORCID record for Rafael Penadés [Opens in a new window] ,
Eduard Vieta Open the ORCID record for Eduard Vieta [Opens in a new window] ,
Eduard Parellada Open the ORCID record for Eduard Parellada [Opens in a new window] ,
Josep Antoni Ramos-Quiroga Open the ORCID record for Josep Antoni Ramos-Quiroga [Opens in a new window] ,
Clarissa S. Gama  and
Norma Verdolini Open the ORCID record for Norma Verdolini [Opens in a new window]
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Silvia Amoretti
Affiliation:
Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
Francisco Diego Rabelo-da-Ponte
Affiliation:
Molecular Psychiatry Laboratory, Hospital de Clínicas de Porto Alegre, Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
Marina Garriga*
Affiliation:
Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
Maria Florencia Forte
Affiliation:
Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain Barcelona Clínic Schizophrenia Unit, Neuroscience Institute, Hospital Clínic of Barcelona, Barcelona, Catalonia, Spain Department of Medicine, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Catalonia, Spain
Rafael Penadés
Affiliation:
Barcelona Clínic Schizophrenia Unit, Neuroscience Institute, Hospital Clínic of Barcelona, Barcelona, Catalonia, Spain Department of Medicine, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Catalonia, Spain
Eduard Vieta
Affiliation:
Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
Eduard Parellada
Affiliation:
Barcelona Clínic Schizophrenia Unit, Neuroscience Institute, Hospital Clínic of Barcelona, Barcelona, Catalonia, Spain Department of Medicine, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Catalonia, Spain
Josep Antoni Ramos-Quiroga
Affiliation:
Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
Clarissa S. Gama
Affiliation:
Molecular Psychiatry Laboratory, Hospital de Clínicas de Porto Alegre, Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
Norma Verdolini
Affiliation:
Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
Byron Bitanihirwe
Affiliation:
Centre for Global Health, Trinity College, Dublin, Ireland Department of Psychology, Trinity College, Dublin, Ireland School of Medicine, Trinity College, Dublin, Ireland
Clemente Garcia-Rizo
Affiliation:
Barcelona Clínic Schizophrenia Unit, Neuroscience Institute, Hospital Clínic of Barcelona, Barcelona, Catalonia, Spain Department of Medicine, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Catalonia, Spain
*
Author for correspondence: Marina Garriga, E-mail: magarriga@clinic.cat
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Abstract

Background

Schizophrenia (SZ) is a complex brain disorder linked to cognitive and neurostructural abnormalities that involves genetic and environmental factors with obstetric complications (OCs) at birth conferring a high risk for the disease. Indeed, current research in the general population describes the deleterious effect of OCs on cognitive performance in adulthood. With this rationale, we aim to review the relationship between OCs and cognition in SZ and related psychotic disorders.

Methods

A systematic review and meta-analysis describing cognitive function and OCs in patients with SZ and related disorders were conducted. PubMed, EmBase, SCOPUS, and the Cochrane Library were systematically searched to identify eligible studies up to January 2022. We calculated the effect sizes (Hedges' g) of cognitive domains within each study and quantified the proportion of between-study variability using the I2 statistic. Homogeneity was assessed using the Q-statistic (X2). The study was registered on PROSPERO (CRD42018094238).

Results

A total of 4124 studies were retrieved, with 10 studies meeting inclusion criteria for the systematic review and eight for meta-analysis. SZ subjects with OCs showed poor verbal memory [Hedges' g = −0.89 (95% CI −1.41 to −0.37), p < 0.001] and working memory performance [Hedges' g = −1.47 (95% CI −2.89 to −0.06), p = 0.01] in a random-effect model compared to those without OCs.

Conclusions

OCs appear to have a moderate impact on specific cognitive such as working memory and verbal memory. Our findings suggest that OCs are associated with brain development and might underlie the cognitive abnormalities described at onset of psychosis.

Keywords

Cognitiondevelopmental origins of health and diseaseneurocognitive profileobstetric complicationspsychosisschizophrenia
Type
Review Article
Information
Psychological Medicine , Volume 52 , Issue 14 , October 2022 , pp. 2874 - 2884
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Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press

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Footnotes

*

These authors contributed equally to the presented work.

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