Læknablaðið : fylgirit - 01.08.2003, Blaðsíða 14

■ ABSTRACTS / 27TH NORDIC PSYCHIATRIC CONGRESS
F - Free Papers
F-1/1 Thursday 14/8,15:00-16:00
Modest excess of obstetric complications in the offspring
of bipolar mothers
Jamcs H. MacCabc Dr„ Clinical Researcher, Division of Psychological Medicine,
Institute of Psychiatry, London, and Dept. of Medical Epidemiology, Karolinska
Instítute, Stockholm, PO 63, Institute of Psychiatry, de Crespigny Park, London SE5
8AE Lennart Martinsson, Paul Lichtenstein, Emma Nilsson, Robin M. Murray,
Christina M. Hultman.
j.maccabe@iop.kcl.ac.uk
Background: The role of pregnancy and birth complications
(PBCs) in the aetiology of bipolar disorder is unclear, with most
studies showing weak associations. The question of whether the
offspring of bipolar mothers are at increased risk of experiencing
obstetric complications has not been investigated.
Aim: To use Swedish national registers to investigate the preva-
lence of 5 PBCs (stillbirth, neonatal death, pre-term delivery, low
birth weight and smallness for gestational age) in the offspring of
mothers with bipolar affective disorder.
Method: The study sample comprised data on 5,618 births to
mothers with bipolar affective disorder, and 1,552,453 births to
mothers without this diagnosis.
Results: We found modest elevations in risk for low birth weight
(unadjusted OR 1.36 (95%CI 1.21-1.55)) and pre-term delivery (OR
1.29 (1.15-1.45)). These associations were attenuated, but remained
significant, after adjusting for maternal age, parity, smoking,
cohabitation, education level, immigrant status, and pregnancy-
induced hypertensive disease. An additional unadjusted association
with smallness for gestational age (OR 1.31 (1.13-1.51) was
accounted for mainly by an excess of smoking in the bipolar group.
Conclusions: It appears that bipolar mothers have a modest excess
of low birth weight and pre-term delivery in their offspring, which
are not accounted for by smoking, nor by a range of other potential
confounders. Possible explanations for this include a small genetic
effect, medication effects, or misdiagnosis of some schizophrenic
mothers as bipolar.
F - 1 / 2 Thursday 14/8,15:00-16:00
Early risk factors for infantile autism: data from the
Swedish Medical Birth Registry
Hultman CM, Research Fellow, Associate Professor, Department of Medical Epidemio-
logy and Biostatistics, Karolinska Institutet, Stockholm, Sweden. Cnattingius S, Sparén P.
Christina. H ultman @mep. ki. se
Background: Etiologic hypotheses in infantile autism suggest a
strong genetic component as well as possible environmental risks
linked to early fetal development. We evaluated the association of
maternal, pregnancy, delivery, and infant characteristics with risks
of infantile autism.
Methods: We conducted a case-control study nested within a popu-
lation-based cohort (all Swedish children born 1974-93). We used
prospectively recorded data from the Swedish Birth Register,
which was individually linked to the Swedish Inpatient Register.
Cases were 408 children (321 boys and 87 girls) discharged with a
main diagnosis of infantile autism from any hospital in Sweden
before 10 years of age 1987-1994 and 2,040 matched controls.
Conditional logistic regression was used to calculate odds ratios
(ORs) and 95% confidence intervals (CIs).
Results: The risk of autism was associated with daily smoking in
early pregnancy (OR = 1.4; CI = 1.1-1.8), maternal birth outside
Europe and North America (OR = 3.0; CI = 1.7-5.2), Cesarean
delivery (OR = 1.6; CI = 1.1-2.3), small-for-gestational-age (OR =
2.1; CI = 1.1-3.9), an Apgar score below 7 at 5 minutes (OR = 3.2,
CI = 1.2-8.2), and congenital malformations (OR = 1.8, CI = 1.1-
3.1). No association was found between autism and head circum-
ference, maternal diabetes, being a twin or season of birth.
Condusions: Our findings suggest that intrauterine and neonatal
factors related to deviant intrauterine growth or fetal distress are
important in the pathogenesis of autism.
F-1/3 Thursday 1/8,15:00-16:00
Childhood motor skills and persistent anxiety in early
adult life
Engilbcrt Sigurðsson, Consultant Psychiatrist, Landspitali University Hospital,
Department of Psychiatry, 101 Hringbraut, Reykjavík, Iceland
engilbs@landspitali. is
Background: Childhood motor impairment have been shown to be
strongly associated with matemally rated persistent anxiety in male
adolescents while no such association has been reported for female
adolescents.
Aims: To test the hypothesis that childhood motor skills are associ-
ated with persistent anxiety in early adulthood.
Method: A historic cohort study. Post hoc analysis of data from the
UK National Child Development Study (n=17,000) to put the
hypothesis to the test within the 1958 UK birth cohort using an
internal comparison group. Odds ratios were used to examine the
effect of motor impairment on persistent anxiety after adjusting for
sex, social class, birth weight, depressive symptoms and, by proxy,
early-onset psychoses.
Rcsults: No association was found between childhood motor delay
and persistent anxiety in early adult life in the cohort. No effect
modification by sex was observed unlike the findings for the same
cohort in adolescence.
Conclusions: While childhood motor delay may be associated with
persistent anxiety in adolescent males, this association does not
seem to extend into adult life in the 1958 UK birth cohort.
F-1/4 Thursday 14/8, 15:00-16:00
Depression and the incidence of first-ever stroke in 85-
year olds
Ingmar Skoog. Professor, Institute of Clinical Neurosciences, Göteborg, University,
Dcpt. of Psychiatry, Sahlgrenska University Hospital, SE-413 45, Göteborg, Sweden.
Liebetrau M, Steen B.
ingmar.skoog@neuro.gu.se
Background: Depression is common after stroke, but only little is
known whether depression increases the risk for stroke.
14 L/EKNABLAÐIÐ / FYLGIRIT 48 2003/89