Birth Complications and Psychological Deviancy: A 25‐Year Prospective Inquiry

Considerable evidence has accumulated during the past 30 years regarding the relationship between pregnancy and delivery complications and a variety of psychiatric and neurologic disorders. Prior studies have suffered from major methodological problems associated with retrospective designs, notably selection and recall biases. We are conducting a 25‐year prospective investigation of perinatal complications and psychiatric outcomes. The study cohort consists of 176 singleton births diagnosed as either “severe toxemia” or “breech delivery” and 176 matched control subjects, all selected from the Providence Center of the National Collaborative Perinatal Project. Extensive obstetrical, neurological, behavioral and socio‐demographic information was collected prospectively for these subjects, from the perinatal period through age seven. Subjects were recontacted (ages 18–24) and admin istered a battery of instruments designed to assess: a) psychiatric diagnosis (using the Diagnostic Interview Schedule); b) cognitive and psychosocial functioning; and c) family history of mental disorders. 85% of the sample have been contacted and 60% successfully interviewed at this time. Preliminary analyses will assess the relative risk associated with each pregnancy complication and the DSM‐III psychiatric diagnoses covered by the Diag nostic Interview Schedule. Further analyses will examine possible etiologic mechanisms which have been proposed to account for such associations.