Macrosomia and psychiatric risk in adolescence
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ORIGINAL CONTRIBUTION
Macrosomia and psychiatric risk in adolescence Ryan J. Van Lieshout1 · Calan D. Savoy1 · Mark A. Ferro2 · John E. Krzeczkowski1 · Ian Colman3 Received: 14 May 2019 / Accepted: 22 December 2019 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract The prenatal environment can exert important effects on mental health. While much research has linked low birth weight to psychopathology, the intrauterine environment associated with high birth weight (macrosomia; > 4000 g) is also sub-optimal and may increase risk. Given the increasing prevalence of macrosomic births, understanding the mental health outcomes of infants born macrosomic can help refine theories of etiology, predict disorder, and target preventive interventions. Using data from the 2014 Ontario Child Health Study (OCHS), we examined the risk for psychiatric disorders in adolescents born macrosomic. Youth (N = 2151) aged 12–17 years completed the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID). Rates of common mental disorders assessed by the MINI-KID were compared between those born at normal birth weight (NBW; 2500–4000 g, n = 1817) and adolescents born macrosomic (> 4000 g, n = 334). These associations were then adjusted for participant age, sex, socioeconomic status (SES) of the family, parental mental health, and gestational diabetes mellitus. After adjustment for covariates, adolescents born macrosomic had higher odds of conduct disorder (CD; OR = 3.19, 95% CI: 1.37–7.43), oppositional defiant disorder (ODD; OR = 1.79, 95% CI: 1.11–2.91), and ADHD (OR = 1.77, 95% CI: 1.21–2.80). Moderation analyses revealed that males born macrosomic were more likely to have psychiatric problems than their female peers. Socioeconomic disadvantage also amplified the risk posed by macrosomia for ODD, ADHD, major depressive disorder, and generalized anxiety disorder. In this study, macrosomia was associated with an increased risk of clinically significant externalizing problems in adolescence, most notably among boys and those facing socioeconomic disadvantage. Keywords Fetal macrosomia · Mental disorders · Early life stress · Sex
Introduction Nearly one in five youth will develop a psychiatric disorder [1] and 50% of adults with mental illness met diagnostic criteria for mental disorders in childhood [2]. The Developmental Origins of Health and Disease (DoHAD) hypothesis posits that exposure to sub-optimal perinatal conditions can * Ryan J. Van Lieshout [email protected] 1
Department of Psychiatry and Behavioural Neurosciences, St. Joseph’s Healthcare Hamilton, McMaster University, West 5th Campus, 100 West 5th Street, Hamilton, ON L8N 3K7, Canada
2
School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, TJB 2311, Waterloo, ON N2L 3G1, Canada
3
School of Epidemiology & Public Health, University of Ottawa, 600 Peter Morand Cr, Room 308C, Ottawa, ON K1G 5Z3, Canada
play a crucial role in the development of health problems later in life,
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