Obstetric complications and psychopathology in schizophrenia: A systematic review and meta-analysis.

Schizophrenia (SZ) is a severe mental health condition involving gene-environment interactions, with obstetric complications (OCs) conferring an elevated risk for the disease. Current research suggests that OCs may exacerbate SZ symptoms. This study conducted a systematic review and meta-analysis to comprehensively evaluate differences in psychopathology between individuals with and without exposure to OCs in relation to SZ and related disorders. We systematically searched PubMed, PsycINFO, and SCOPUS to identify eligible studies. A total of 4,091 records were retrieved through systematic and citation searches. 14 studies were included in the review, and 12 met the criteria for meta-analysis, involving 2,992 patients. The analysis revealed that SZ patients who had been exposed to OCs exhibited significantly higher levels of positive symptoms (SMD=0.10, 95%CI=0.01,0.20; p=0.03), general psychopathology (SMD=0.37, 95%CI=0.22,0.52; p<0.001), total clinical symptomatology (SMD=0.44, 95%CI=0.24,0.64; p<0.001) and depressive symptoms (SMD=0.47, 95%CI=0.09,0.84; p=0.01). No significant differences were found in negative symptomatology and functioning. Our results suggest that OCs are not only associated with an increased risk of developing psychosis but with more severe symptomatology.

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Conflicts of interest C. García-Rizo has received honoraria/travel support from Abbot, Angelini, Cassen-Recordati, Janssen-Cilag, Lundbeck, with no financial or other relationship relevant to the subject of this article. G. Mezquida has received honoraria support from Boehringer Ingelheim, with no financial or other relationship relevant to the subject of this article. S. Amoretti has been a consultant to and/or has received honoraria/grants from Otsuka-Lundbeck, with no financial or other relationship relevant to the subject of this article. M. Garriga has received honoraria/travel support from Ferrer, Janssen-Cilag, and Lundbeck, with no financial or other relationship relevant to the subject of this article. E. Vieta has received grants and served as consultant, advisor or CME speaker for the following entities: AB-Biotics, AbbVie, Adamed, Alcediag, Angelini, Biogen, Beckley-Psytech, Biohaven, Boehringer-Ingelheim, Celon Pharma, Compass, Dainippon Sumitomo Pharma, Ethypharm, Ferrer, Gedeon Richter, GH Research, Glaxo-Smith Kline, HMNC, Idorsia, Johnson & Johnson, Lundbeck, Luye Pharma, Medincell, Merck, Newron, Novartis, Orion Corporation, Organon, Otsuka, Roche, Rovi, Sage, Sanofi-Aventis, Sunovion, Takeda, Teva, and Viatris, outside the submitted work. E. Parellada has received honoraria and/or research grants and/or financial support for the Basic and Translational Research Laboratory in Schizophrenia from the following entities: Fondo de Investigación Sanitaria of the Spanish Ministry of Science and Innovation, the Catalan Pons Balmes Grant, Fundació la Marató de TV3 of Catalonia, Família Cunillera, Relats, Assegurances Santasusana, Fundació Vila-Saborit, Janssen-Cilag, Adamed, Rovi, Boehringer-Ingelheim, Lundbeck-Otsuka, Ferrer, Angelini, Sanofi, Almirall, Kern, Advanz Pharma, Casen Recordati, Takeda, Biogen, GWA and Acadia. J.A. Ramos-Quiroga was on the speakers’ bureau and/or acted as consultant for Biogen, Idorsia, Casen-Recordati, Janssen-Cilag, Novartis, Takeda, Bial, Sincrolab, Neuraxpharm, Novartis, BMS, Medice, Rubió, Uriach, Technofarma and Raffo in the last 3 years. He also received travel awards (air tickets + hotel) for taking part in psychiatric meetings from Idorsia, Janssen-Cilag, Rubió, Takeda, Bial and Medice. The Department of Psychiatry chaired by him received unrestricted educational and research support from the following companies in the last 3 years: Exeltis, Idorsia, Janssen- Cilag, Neuraxpharm, Oryzon, Roche, Probitas and Rubió. I. Baeza has received honoraria o support to attend conferences from Angelini and Lundbeck, with no financial or other relationship relevant to the subject of this article. The rest of authors report no biomedical financial interests or potential conflicts of interest.