Prenatal, Perinatal, and Postnatal Risk Factors in Obsessive-Compulsive Disorder

Vasconcelos MS, Sampaio AS, Hounie AG, Akkerman F, Curi M, Lopes AC, Miguel EC.

Department of Psychiatry, University of Sao Paulo Medical School, OCD Spectrum Disorders Program, Sao Paulo, Brazil.

Background: The etiology of obsessive-compulsive disorder (OCD) remains unknown, although it is thought to involve an interaction of genetic and environmental factors. This study aimed to identify prenatal, perinatal, and postnatal risk factors in OCD.

Methods: We compared retrospectively 68 OCD patients to 70 control subjects based on responses given on a standardized questionnaire. The questionnaire was designed to evaluate environmental factors, with a special focus on gestation, labor, birth, and early infancy aspects.

Results: The group of OCD patients had risk factors with greater frequency than the control group. Notable among the significant findings (p = 0.001) were edema of the hands, feet, or face and excessive weight gain during gestation; hyperemesis gravidarum; prolonged labor; preterm birth; and jaundice. When socioeconomic class was used as a covariable in the logistic regression analysis, prolonged labor and edema during pregnancy remained statistically significant.

Conclusions: Some early risk factors may be associated with the expression of OCD later in life such as edema during pregnancy and prolonged labor. If our findings are confirmed in future studies, greater attention should be given to such factors in predisposed individuals, especially in prenatal care and delivery.

(Text has been reformatted for clarity; ed.)