The present study examined the association between perinatal obstetric complications and executive dysfunction in early-onset schizophrenia (EOS), compared to healthy controls. Higher incidences of obstetric complications and more severe executive dysfunctions characterize EOS. Research shows extensive brain maturation in newborns, suggesting them to be particularly vulnerable for perinatal insults. Executive function is mainly mediated by the prefrontal cortex, an area that matures last during pregnancy. Thus, exposure to perinatal complications may influence executive dysfunction in EOS. The participants were 19 EOS patients and 54 healthy controls. Executive function was assessed with the D-KEFS Color Word Interference Test and the Wisconsin Card Sorting Test. Information on perinatal obstetric complications and Apgar 5-min scores were obtained from the Norwegian Medical Birth Registry. Associations between perinatal conditions and executive function were studied using stepwise regression analyses. Perinatal complications, and especially shorter gestational lengths, were significantly associated with significant executive dysfunctions in EOS. Perinatal complications did not affect executive function among healthy controls. A significant relationship between lower Apgar 5-min scores and executive dysfunction was found among both EOS patients and healthy controls. Exposure to perinatal complications, and particularly a shorter gestational length, was associated with increased executive dysfunction in EOS. Exposed healthy controls did not exhibit similar executive difficulties, suggesting that the EOS patients seemed especially vulnerable for executive deficits due to perinatal insults. The findings indicate that EOS youths learn more slowly and experience more difficulty with problem-solving, which carry important implications for clinical practice. Lower Apgar 5-min scores were associated with executive dysfunction in both groups. Low Apgar score at 5 min may therefore be an important early indicator of executive difficulties among adolescents, independent of diagnosis.

中文翻译：

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早发性精神分裂症的围产期并发症和执行功能障碍。

本研究检查了与健康对照相比，早发性精神分裂症（EOS）围产期产科并发症与执行功能障碍之间的关系。EOS的特征是产科并发症发生率更高，执行功能障碍更严重。研究表明，新生儿的大脑发育成熟，表明他们特别容易受到围产期伤害。执行功能主要由前额叶皮层介导，前额叶皮层在怀孕期间最后成熟。因此，暴露于围产期并发症可能会影响EOS的执行功能障碍。参与者是19名EOS患者和54名健康对照。执行功能通过D-KEFS颜色词干扰测试和威斯康星卡片分类测试进行评估。有关围产期产科并发症和Apgar 5分钟评分的信息可从挪威医疗出生登记处获得。使用逐步回归分析研究围产期状况和执行功能之间的关联。围产期并发症，尤其是较短的孕期，与EOS的严重执行功能异常显着相关。围产期并发症并未影响健康对照者的执行功能。在EOS患者和健康对照者中，发现较低的Apgar 5分钟评分与执行功能障碍之间存在显着关系。暴露于围产期并发症，特别是缩短孕期，与EOS的执行功能障碍增加有关。暴露的健康对照没有表现出类似的执行困难，这表明，由于围产期侮辱，EOS患者似乎特别容易出现执行缺陷。研究结果表明，EOS年轻人的学习速度较慢，解决问题的难度更大，这对临床实践具有重要意义。两组中较低的Apgar 5分钟评分均与执行功能障碍相关。因此，与诊断无关，5分钟Apgar评分低可能是青少年执行困难的重要早期指标。