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    Postpartum depression on the decline

     

    The impact of severe lack of nutrition on risk of psychoses in offspring

    When women are exposed to a severe lack of nutrition during pregnancy, offspring may face an increased risk of nonaffective psychoses, according to results of a study published in JAMA Psychiatry.

    Researchers used data from Swedish health and population registers to follow up more than a half million people who were born between January 1982 and December 1989 from the time they were age 13 years until December 2011. Family-based study designs were used to test causality. The authors also used Cox proportional hazards regression models for socioeconomic status and potential risk factors to look at risk of developing nonaffective psychoses.

    Of the 526,042 people in the cohort (48.52% female and 51.47% male; mean [SD] age, 26 [2.3] years), 2910 people had nonaffective psychoses at the end of the follow-up, of whom 704 had narrowly defined schizophrenia. Among those with nonaffective psychosis, 184 (6.32%) had mothers with extremely inadequate gestational weight gain (<8 kg for mothers with normal baseline body mass index [BMI]), while 23,627 (4.52%) of unaffected individuals had mothers with extremely inadequate gestational weight gain. Such extremely inadequate gestational weight gain was linked with an increased risk of nonaffective psychoses among offspring in adjusted models (hazard ratio [HR], 1.32; 95% confidence interval [CI], 1.13-1.54) as well as in matched-sibling analysis (HR, 1.61; 95% CI, 1.02-2.56).

    A weak association was seen between maternal mild thinness in early pregnancy and an increased risk of nonaffective psychosis in offspring (HR for BMI ≥ 17.0 and <18.5, 1.21; 95% CI, 1.01-1.45) in mutually adjusted models. A similar association was seen with paternal severe thinness (HR for BMI<16.0, 2.53; 95% CI, 1.26-5.07). No association was seen between maternal underweight (HR, 1.46; 95% CI, 0.90-2.35), overweight (HR, 1.11; 95% CI, 0.73-1.68), or obesity (HR, 0.56; 95% CI, 0.23-1.38) and the risk of nonaffective psychosis in offspring in matched-sibling analysis.

    The researchers concluded that insufficient weight gain during pregnancy was linked with an increased risk for nonaffective psychoses in offspring, which is consistent with historical studies examining the impact of maternal starvation.

    Judith M. Orvos, ELS
    Judith M. Orvos, ELS, is a a BELS-certified medical writer and editor and an editorial consultant for Contemporary OB/GYN.
    Miranda Hester
    Ms. Hester is Content Specialist with Contemporary OB/GYN and Contemporary Pediatrics.

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