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Castro-Fornirles JAuthorValli ICorresponding AuthorVerdolini NAuthorGarcia-Rizo CCorresponding AuthorBaeza IAuthorMartinez-Arán AAuthorMezquida GAuthorMas SAuthorBernardo MAuthorVieta EAuthorAmoretti SAuthorBorras RAuthorDe La Serna EAuthorMadero SAuthor

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Article

Obstetric complications and genetic risk for schizophrenia: differential role of antenatal and perinatal events in first episode psychosis

Publicated to:Acta Psychiatrica Scandinavica. 148 (1): 81-90 - 2023-07-01 148(1), DOI: 10.1111/acps.13546

Authors: Valli, Isabel; Segura, Alex Gonzalez; Verdolini, Norma; Garcia-Rizo, Clemente; Berge, Daniel; Baeza, Inmaculada J; Cuesta, Manuel; Gonzalez-Pinto, Ana; Lobo, Antonio; Martinez-Aran, Anabel; Mezquida, Gisela; Pina-Camacho, Laura; Bejarano, Alexandra Roldan; Mas, Sergi; McGuire, Philip; Bernardo, Miquel; Vieta, Eduard

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Abstract

Obstetric complications (OCs) are key contributors to psychosis risk. However, it is unclear whether they increase psychosis vulnerability independently of genetic risk, in interaction with it, or are a manifestation of psychosis proneness. We examined the role of distinct types of OCs in terms of psychosis risk and tested whether they interact differently with genetic vulnerability, whilst accounting for other known environmental risk factors. Study Design 405 participants (219 first episode psychosis patients and 186 healthy volunteers) underwent a comprehensive assessment of OCs, measured using the Lewis-Murray scale and divided into complications of pregnancy, abnormalities of fetal growth and development, and complications of delivery. Participants were compared in terms of history of OCs, polygenic risk score for schizophrenia (PRS-SZ) and interactions between these.Both complications of pregnancy and abnormalities of fetal growth were significantly associated with case-control status (p=0.02 and 0.03 respectively), whereas complications of delivery were not. PRS-SZ showed a significant association with psychosis (p=0.04), but there were no significant interactions between genetic risk for schizophrenia and OCs, either when these were considered globally or separated based on their timeframe.We observed no significant interaction between genetic and obstetric vulnerability, yet distinct types of OCs may have a different impact on psychosis risk, based on their nature and timeframe. Examining their differential role might clarify their relative contributions to this risk. This article is protected by copyright. All rights reserved.This article is protected by copyright. All rights reserved.

Keywords

CannabisComplicationEnvironmentalFemaleFundingGeneticsHumanHumansHypoxiaLabor complicationMultifactorial inheritanceObstetric labor complicationsPlacentaPolygenic risk scorePregnancyPsychosisPsychotic disordersRisk factorRisk factorsSchizophreniaUtero

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Acta Psychiatrica Scandinavica due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2023, it was in position 28/279, thus managing to position itself as a Q1 (Primer Cuartil), in the category Psychiatry. Notably, the journal is positioned above the 90th percentile.

From a relative perspective, and based on the normalized impact indicator calculated from World Citations provided by WoS (ESI, Clarivate), it yields a value for the citation normalization relative to the expected citation rate of: 1.55. This indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: ESI Nov 14, 2024)

This information is reinforced by other indicators of the same type, which, although dynamic over time and dependent on the set of average global citations at the time of their calculation, consistently position the work at some point among the top 50% most cited in its field:

  • Field Citation Ratio (FCR) from Dimensions: 3.86 (source consulted: Dimensions Jun 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-06-03, the following number of citations:

  • WoS: 6
  • Scopus: 6
  • OpenCitations: 8

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-06-03:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 27.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 27 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 3.
  • The number of mentions on the social network X (formerly Twitter): 7 (Altmetric).

Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: Italy; Peru; United Kingdom.

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: First Author (Valli, Isabel) .

the authors responsible for correspondence tasks have been Valli, Isabel and García Rizo, Clemente.