Objective: Previous research has linked maternal anemia during pregnancy with increased risk for schizophrenia in offspring. However, no study has sought to determine whether this early insult leads to a more severe form of the disorder, characterized by worsened motor and neurocognitive functioning. Method: Subjects were 24 cases diagnosed with schizophrenia and 22 controls from the Developmental Insult and Brain Anomaly in Schizophrenia (DIBS) study. Hemoglobin values were measured throughout pregnancy. Among offspring, psychiatric diagnoses were determined through semi-structured interviews and medical records review and comprehensive neurocognitive assessment batteries were conducted in adulthood. Results: Results indicated that among cases decreases in maternal hemoglobin led to significant decreases in scores on the Grooved Pegboard test, the Finger Tapping test and the Wechsler Adult Intelligent Scales (WAIS) information subtest. In contrast, controls only exhibited decreases in performance on the California Verbal Learning Test (CVLT) long-delay recall after fetal exposure to lower hemoglobin. There were also significant interactions between hemoglobin and case status for all of the motor tasks. Conclusions: These findings support the hypothesis that fetal exposure to decreases in maternal hemoglobin is related to preferentially poorer neuromotor function among cases compared to controls, as well as general intellectual difficulties among cases. Controls were relatively unaffected by decreased maternal hemoglobin, which suggests that liability to schizophrenia renders cases susceptible to the deleterious influences of in utero exposure to decreases in maternal hemoglobin.
Bibliographical noteFunding Information:
This study was supported by research grants to Dr. Brown from the National Institute of Mental Health ( R01MH060249 , R01MH63264 , K02 MH065422-06 ) and a postdoctoral NIMH schizophrenia research fellowship to Dr. Ellman ( 5T32 MH018870-20 ), and grants N01HD13334 and N01HD63258 from The Eunice Kennedy Shriver Institute of Child Health and Human Development . We also thank Ezra Susser, Catherine Schaefer, Michaeline Bresnahan, Barbara Cohn, Connor Puleo, Anna Fineberg, Lauren Lombardo, Jessica Winsell, and the study teams of the Child Health and Development Study, the Prenatal Determinants of Schizophrenia study, and the Developmental Anomaly in Schizophrenia study for their contributions to data collection and preparation of this manuscript.
This study was supported by research grants to Dr. Brown from the National Institute of Mental Health (R01MH060249, R01MH63264, K02 MH065422-06) and a postdoctoral NIMH schizophrenia research fellowship to Dr. Ellman (5T32 MH018870-20), and grants N01HD13334 and N01HD63258 from The Eunice Kennedy Shriver Institute of Child Health and Human Development. These funding sources had no role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.
- Cognitive outcomes
- Obstetric complications