Obstetric, perinatal difficulties ‘not linked to bipolar disorder risk’

By Mark Cowen

Results from a US study indicate that obstetric and perinatal difficulties are not associated with an increased risk for bipolar disorder in children.

However, Timothy Wilens (Massachusetts General Hospital, Boston) and team found that children with bipolar disorder were more likely to have "acted colicky" in infanthood and to have been "stiffened infants" than those without the mood disorder.

To investigate whether obstetric, perinatal, and infantile difficulties are associated with bipolar disorder risk in children, the researchers studied data on 338 children, aged a mean of 12 years, who participated in two longitudinal, case-control family studies.

The participants were divided into three groups comprising 120 children with bipolar disorder, 120 of their non-affected siblings, and 98 unrelated mentally healthy children (controls).

Mothers of the participants completed questionnaires regarding obstetric complications (eg, breech delivery, cesarean section, and labor longer than 24 hours), perinatal difficulties (eg, placement in an incubator, low birth weight, need for surgery, extended hospital stay), and infant behavior (eg, constant crying, unusually quiet infant, stiffened infant, floppy infant, vomiting).

The researchers found that the mothers of children with bipolar disorder were no more likely to report obstetric or perinatal difficulties than other mothers.

However, the mothers of children with the mood disorder were significantly more likely to report infant behavioral difficulties than the mothers of controls, at an odds ratio (OR) of 6.6.

Specifically, children with bipolar disorder were more likely to have been "stiffened infants" (OR=7.2) and more likely to have experienced "other" infantile difficulties (OR=4.9), including "acting colicky," than other children.

Wilens and team conclude in Bipolar Disorders: "Our current data support infantile difficulties as potential prognostic indicators for pediatric bipolar disorder or as early manifestations of later psychopathology."

They add: "Further research on these difficulties and their relationship to familial and genetic interactions is necessary to lead to a better understanding regarding the etiology and prevention of pediatric bipolar disorder."

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