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P Rantakallio

Publications and source records attributed to P Rantakallio.

At least 19 recordsLinked to original sources
PubMed1998

Cumulative incidence of lumbar disc diseases leading to hospitalization up to the age of 28 years.

STUDY DESIGN: A cohort study of 12,000 persons with a follow-up period ranging from birth to the age of 28 years. OBJECTIVES: To determine the cumulative incidence of lumbar disc disease leading to hospitalization in a well-defined geographic population, with special emphasis on age of onset and differences between the genders and among disease categories. SUMMARY OF BACKGROUND DATA: There are few published reports on low back pain in adolescence, and most of them are cross-sectional in design. METHODS: The Finnish National Hospital Discharge Register was used to identify all possible cases of lumbar disc disease. Copies of all hospital records regarding the diagnosis and course of the disease were collected and the hospitalizations were classified into three categories: 1) confirmed herniated nucleus pulposus (HNP), 2) unconfirmed HNP (sciatica symptoms without visible herniation), and 3) other low back diseases. The patients were classified according to the highest category of diagnosis achieved by each. RESULTS: Symptomatic low back pain leading to hospitalization first appeared around the age of 15 years, and the incidence rose more sharply from the age of 19, especially in men with other low back diseases. Men were hospitalized more than twice as often as women. CONCLUSIONS: Lumbar disc diseases leading to hospitalization begin early.

Adult↗
PubMed1998

School performance as a predictor of psychiatric hospitalization in adult life. A 28-year follow-up in the Northern Finland 1966 Birth Cohort.

BACKGROUND: Deterioration in school achievement may pre-date adult mental disorders. We studied the association between compulsory school performance and later onset hospital-treated psychiatric morbidity experienced by the Northern Finland 1966 Birth Cohort (N = 11017) in adult life. METHODS: School performance was operationalized in two ways: school class level (in normal, i.e. age-appropriate class v. not in normal class, i.e. class below age level or in special school) at the age of 14, and marks for individual school subjects at the age of 16. School class level was ascertained by postal questionnaire and school marks from national application register. These were linked to data on psychiatric morbidity from the National Finnish Hospital Discharge Register. By the end of 1994 (between ages 16 and 28 years), a total of 383 subjects had psychiatric illness. DSM-III-R diagnoses were grouped into three categories: schizophrenia; other psychoses; and non-psychotic disorders. The remaining population with no psychiatric hospitalization served as a single comparison group. School class level and values of school marks in the three diagnostic categories were each compared with this comparison group, stratified by sex. RESULTS: In the comparison group 6.8% of boys and 3.4% of girls were not in their normal class. In all the diagnosis groups the proportions of those not in normal class were from 2 to 8 times higher than in the comparison group. A majority of those not in normal class and having psychiatric diagnosis were intellectually subnormal (IQ < 85). Among adolescents who later developed nonpsychotic disorders, means of school marks were lower (P < 0.05, adjusted for social class and place of residence) than in the comparison group. Lower marks were not found in categories schizophrenia or other psychoses. Logistic regression analysis confirmed these findings after adjustment for confounding factors. CONCLUSIONS: Not being in the normal class at age 14 predicted future hospital-treated disorders, but low school marks at age 16 predicted only non-psychotic disorders. These findings may be an early manifestation of the disorders themselves, or a marker of vulnerability or other risk factors. The mechanisms may differ between diagnoses.

Achievement↗
PubMed1998

Schizophrenia, alcohol abuse, and violent behavior: a 26-year followup study of an unselected birth cohort.

It has been suggested that schizophrenia and alcoholism are associated with violent behavior. But so far there are no published studies from unselected cohorts quantifying the actual risk associated with schizophrenia both with and without comorbid alcoholism. In this study, an unselected birth cohort (n = 11,017) was prospectively followed to the age of 26, and data on psychiatric disorders and crimes were collected from national registers. The odds ratios for violent offenses and recidivism were calculated for each diagnostic group. Men who abused alcohol and were diagnosed with schizophrenia were 25.2 (95% confidence interval (CI) 6.1-97.5) times more likely to commit violent crimes than mentally healthy men. The risk for nonalcoholic patients with schizophrenia was 3.6 (95% CI 0.9-12.3) and for other psychoses, 7.7 (95% CI 2.2-23.9). None of the patients with schizophrenia who did not abuse alcohol were recidivists (> 2 offenses), but the risk for committing more crimes among alcoholic subjects with schizophrenia was 9.5-fold (95% CI 2.7-30.0). This study suggests that to prevent the crimes being committed by people with schizophrenia, it is important that clinicians watch for comorbid alcohol abuse.

Adolescent↗
PubMed1998

Schizophrenia as a long-term outcome of pregnancy, delivery, and perinatal complications: a 28-year follow-up of the 1966 north Finland general population birth cohort.

OBJECTIVE: The 1966 North Finland general population birth cohort was studied to determine whether abnormalities during pregnancy, delivery, and the neonatal period are associated with adult-onset schizophrenia. METHOD: The authors included all 11,017 subjects alive in Finland at age 16. For each individual, standardized assessments made during pregnancy, delivery, and infancy were linked to national psychiatric case registers covering the period up to age 28. Subjects with DSM-III-R schizophrenia were identified by using a two-stage screen that included perusal of individual case records. Associations (adjusted odds ratios) between schizophrenia and specific pregnancy, delivery, and neonatal characteristics were calculated. RESULTS: Within this cohort, 76 cases of DSM-III-R schizophrenia arose by age 28 years; 51 (67.1%) of these persons were men. Demographic characteristics and previous obstetric histories of the mothers were similar in the case and unaffected comparison groups, although the former were more likely to have been more depressed than usual during pregnancy. Low birth weight (< 2500 g) and the combination of low birth weight and short gestation (< 37 weeks) were more common among the schizophrenic subjects. Being small for gestational age (< 10th percentile) was not more common. Of 125 survivors of severe perinatal brain damage, six (4.8%) later developed schizophrenia. CONCLUSIONS: The spectrum of adverse outcomes after fetal and perinatal insults unfolded beyond childhood and included adult-onset schizophrenia. The findings have implications for understanding the mechanisms involved in the development of schizophrenia and, possibly, for its prevention.

Adolescent↗
PubMed1998

Low birth weight in China and Finland.

Although a developing country, China has a lower occurrence of low birth weight (LBW) than many developed countries. This study of two population-based one-year birth cohorts, from Finland in 1985-86 and China in 1992, shows the occurrence of low birth weight (LBW) (1000- < 2500 g) among singletons to be 2.6 percent in the Chinese cohort and 3.0 percent in the Finnish one, and that of preterm births (28- < 37 weeks) 2.7 percent and 4.5 percent, respectively. The main component of LBW is term LBW (57.4 percent) in the Chinese case and preterm LBW (64.7 percent) in the Finnish case. The perinatal mortality rate (PMR) was twice as high in the Chinese cohort (13.0 vs. 5.9 per thousand). The occurrence of LBW in the Finnish cohort decreased to 2.3 percent after crosstabulation of the Finnish mothers to conform in structure to the population of Chinese mothers in terms of maternal age, marital status and maternal smoking. The result suggests that the lower incidence of LBW in the Chinese cohort seems to be a reflection of the Chinese socio-cultural environment, which provides Chinese mothers with favourable characteristics. The Finnish excess LBW would have disappeared if the mothers had possessed those characteristics as well. The excess perinatal deaths in the Chinese series might be explained by the different levels of perinatal health care in the two countries.

China↗
PubMed1998

Mortality and hospitalizations of 24-year-old members of the low-birthweight cohort in northern Finland.

We followed 11,355 children born in 1966 up to the age of 24 years to investigate the impact of birthweight on long-term outcomes of death and development. As expected, low-birthweight (LBW, 1500-2,499 gm) children showed a higher risk of death than normal-birthweight (NBW, > or =2,500 gm) children before the age of 15 years. Rate ratios for LBW children ranged from 25 for the first week of life to 2.5 for ages 5-14 years. Rate ratios of very-low-birthweight (VLBW, <1,500 gm) children for the first year of life were 10 times higher than those of LBW children. Similarly, for the first 14 years of life, surviving LBW children experienced a higher risk of being hospitalized as well as staying in hospitals for over 2 weeks if they were hospitalized. The LBW children still had a higher risk of receiving sick pensions at the age of 24 years.

Adolescent↗
PubMed1997

Is a child's risk of early onset schizophrenia increased in the highest social class?

In a sample from the unselected, general population Northern Finland 1966 Birth Cohort, 11017 individuals alive at the age of 16 years were studied until the age of 27. The cumulative incidence of early onset schizophrenia until 23 years was higher (1.14%; 9/792) among young persons from the highest social class or class I (determined according to father's occupation) than among children from lower social classes (0.47%; 48/10225), the difference being statistically significant (p < 0.05). The incidence of schizophrenia in the highest social class was higher than expected among girls, firstborns, children of young mothers under 30 and urban residents (p < 0.05) compared with lower social classes. When cases from the highest and other social classes were compared, there was no clear difference in background factors or clinical course. Four alcoholics, one of them also schizophrenic, were found among nine social class I fathers. The results suggest that in some families in Northern Finland, a father's professional advancement, often linked to mental disorder, may be one determinant of an increased risk of schizophrenia in the child.

Adolescent↗
PubMed1997

Association between central nervous system infections during childhood and adult onset schizophrenia and other psychoses: a 28-year follow-up.

BACKGROUND: Maternal exposure to influenza epidemics during pregnancy may increase the risk of schizophrenia in the offspring. We investigated the association between central nervous system (CNS) infections defined prospectively up to the age of 14, and later onset of schizophrenia and other psychoses in the 1966 birth cohort in Northern Finland, which covers 96% of all births in the area during that year. METHODS: Data regarding CNS infections were collected 1966-1980. Registered diagnoses of psychoses in 1982-1993 were validated on DSM-III-R criteria. RESULTS: Out of 11,017 subjects, 145 had suffered a CNS infection during childhood, 102 of them a viral infection, 76 had DSM-III-R schizophrenia and 53 some other psychosis. Four cases of schizophrenia had suffered viral CNS infection and two cases of other psychosis bacterial infection. When neurological abnormalities and father's social class were adjusted odds ratio (OR) of schizophrenia after viral CNS infection was 4.8 (95% confidence intervals [CI] : 1.6-14.0); the other significant risk factors being intelligence quotient (IQ) < 85, perinatal brain damage and male sex but not epilepsy. Similarly adjusted OR of other psychoses was 6.9 (95% CI: 1.4-32.8) after bacterial CNS infection; the other significant risk factors being IQ < 85 and severe hearing defect. Two of the live viral infections were caused by Coxsackie B5 during an epidemic in which 16 neonates were infected together. CONCLUSIONS: Central nervous system infections during childhood clearly carried an increased risk of adult onset schizophrenia or other psychoses, viral infections being important for schizophrenia, particularly Coxsackie B5 during the newborn period.

Adolescent↗
PubMed1997

Ecological and individual predictors of birthweight in a northern Finland birth cohort 1986.

This multilevel study of spatial variability in, and determinants of, birthweight was conducted using individual and ecological data in a geographically defined prospective birth cohort for 1986 in northern Finland. The study area comprises three large areas defined by latitude: Northern Lapland (NL), Southern Lapland (SL) and Oulu province (OP), comprising 74 localities with a total study population of 9216 singleton births. The mean birthweight was 3482 g for NL, 3537 g for SL and 3587 g for OP (NL vs. OP and SL vs. OP: P < 0.05). The crude rate for stillbirths was highest in NL. The women in the northernmost area were socially less privileged and the localities less prosperous compared with those in the southernmost area. Significant spatial clustering of mean birthweights was found (P = 0.0016), with highest birthweight in the south-western part of the study area. A variable expressing the wealth of each locality, the financial capacity category (FCC), had its lowest mean value in NL, with a range of one to six for the localities studied here. A multilevel multiple regression model showed that, after allowing for sex, gestational age, mother's age, height and hypertensive disorders, parity, body mass index, previous low birthweight child and smoking as individual determinants of birthweight, part of the residual variation could be explained by the locality wealth parameter. Using the multilevel model, the differences in mean birthweight across the three latitude areas persisted but were reduced (difference OP vs. NL reduced from 105 g to 86.5 g). The relationship between birthweight and FCC was inverse U-shaped with the highest mean birthweight estimated for localities occurring in the middle of the range (FCC = 3). The wealthiest urban localities (FCC = 6) and the most deprived localities (FCC = 1) both had a predicted birthweight about 60 g below the maximum at FCC = 3, if all other factors were held constant. This result, taken together with the spatial clustering of birthweights, suggests that there may be important social and environmental determinants of birthweight that have yet to be identified.

Adult↗
PubMed1996

Use of psychotropic drugs and pregnancy outcome.

This study reports the use of psychotropic drugs and pregnancy outcome in a prospective survey carried out in northern Finland in 1985-1986, consisting of 7933 pregnant women and their 8030 births. Of the mothers, 120 (1.5%) used psychotropic drugs during pregnancy and of them 26 (0.3% of the total) used these drugs before and during the pregnancy. According to the logistic regression analysis, the biological and social background variables associating significantly with the use of these drugs were maternal advanced age and multiparity (> 35 years and > 4 parous), overweight (body mass index > the 90th percentile), smoking, alcohol use, belonging to social class IV, and failure to ensure contraception. The users needed hospital observation significantly more often during pregnancy (regular users, 80.8%; occasional users, 38.3; nonusers, 27.4%) and the adjustment of the background variables did not change this result. Of the pregnancy complications bleeding was significantly more common among users than nonusers (23.3 vs. 13.2%) and this difference was not explained by difference in background variables. The mean birth weight of infants of the regular users was significantly lower (255 g) when background variables were standardized by linear regression analysis. No association of increased number of birth defects was found with usage of psychotropic drugs.

Adult↗
PubMed1996

Body size and mortality in women: a 29 year follow up of 12,000 pregnant women in northern Finland.

STUDY OBJECTIVE: To examine the association between body height, body mass index (BMI), and mortality in fertile women of childbearing age. DESIGN: A prospective cohort study with a 29 year mortality follow up. SETTING AND PARTICIPANTS: A cohort of women (n = 11,997) expected to deliver during 1966 in two northern provinces of Finland. Data on height and pre-pregnancy weight, collected with those on sociodemographic characteristics and smoking by questionnaire at the third trimester, were provided by 91% of the participants. Follow up for mortality using national registries was from delivery until the end of 1994. MAIN RESULTS: Height had a 'U' shaped association with total mortality over the whole follow up time. In women who were shorter than average, the death rate from cardiovascular diseases was increased and in taller women this was true for tumours. Compared with the women of 'normal weight' (BMI 21 to < 25 kg/m2), the obese subjects (BMI at least 29) did not have increased mortality during the first 20 years, but had a relative risk of 1.7 during the final nine years of follow up, primarily as a result of cardiovascular diseases. The lean women (BMI < 21) experienced a similar rate overall, but moderately overweight women (BMI 25 to < 29) had a consistently lower mortality than women of normal weight. CONCLUSIONS: Among fertile women of childbearing age, both the short and tall seem to have an increased total mortality compared with those of average body height, resulting from opposite trends in major causes of death. Obesity is associated with raised long term total mortality.

Adolescent↗
PubMed1996

Unwantedness of a pregnancy and schizophrenia in the child.

BACKGROUND: Maternal stress during pregnancy has been suggested as a risk factor for schizophrenia. We tested the hypothesis that being the child of an unwanted pregnancy would be associated with later schizophrenia. METHODS: Data were collected prospectively in the Northern Finland 1966 Birth Cohort of 11 017 individuals. In the sixth or seventh month of pregnancy mothers were asked whether the pregnancy was wanted, mistimed but wanted or unwanted. Schizophrenia diagnoses in the cohort members were obtained from the Finnish Hospital Discharge Register. RESULTS: Seventy-six cases of DSM-III-R schizophrenia were identified in the whole cohort between the ages of 16 and 28 years; a cumulative incidence of 0.7%, compared with 1.5% for those born from unwanted pregnancies. The risk of later schizophrenia among unwanted children was raised compared with wanted or mistimed children, even after adjustment for confounding by sociodemographic, pregnancy and perinatal variables (OR 2.4; 95% CI 1.2-4.8). CONCLUSIONS: The results suggest that unwantedness may operate either directly as a psychosocial stress during development making children more liable to schizophrenia, or it may be a marker for behaviours associated with risk in either the mother or the child.

Adolescent↗
PubMed1995

Epidemiology of preterm delivery in two birth cohorts with an interval of 20 years.

The occurrence and determinants of preterm delivery were studied in two population-based birth cohorts from northern Finland. In the first cohort of 1966 there were 11,475 singleton deliveries and in the later cohort of 1985-1986, 8,888. The overall incidence (percentage) of preterm deliveries fell from 9.1 to 4.8, including a reduction from 8.8 to 3.4 for spontaneous preterm deliveries. For iatrogenic ones, however, there was an increase from 0.3 to 1.4. The relative risks, associated with such known maternal determinants as unmarried status, smoking, low educational level, age over 34 years, unwantedness of the pregnancy, and poor earlier obstetric history, had about the same level in these two series. However, despite a favorable change in the distribution of most of these determinants over the 20 years, only a small part of the decrease of the total incidence of preterm delivery could be attributed to these changes, as a consistent and substantial reduction occurred in the incidence of spontaneous preterm birth in all categories of each single determinant. The increase in the proportion of iatrogenic preterm deliveries was accompanied by these being more common at lower than at higher socioeconomic levels in 1985-1986, whereas the social gradient appeared to be reversed in 1966.

Cohort Studies↗
PubMed1995

A 28 year follow up of mortality among women who smoked during pregnancy.

OBJECTIVE: To investigate long term mortality among women who smoked during pregnancy and those who stopped smoking. DESIGN: A follow up of a geographically defined cohort from 1966 through to 1993. SUBJECTS: 11,994 women in northern Finland expected to deliver in 1966, comprising 96% of all women giving birth in the area during that year. Smoking habits were recorded during pregnancy but not later. MAIN OUTCOME MEASURE: Mortality by cause (571 deaths). RESULTS: The mortality ratio adjusted for age, place of residence, years of education and marital status was 2.3 (95% confidence interval 1.8 to 2.8) for the women who smoked during pregnancy and 1.6 (1.1 to 2.2) for those who stopped smoking before the second month of pregnancy, both compared with non-smokers. Among the smokers the relative mortality was higher for typical diseases related to tobacco intake, such as respiratory and oesophageal cancer and diseases of the cardiovascular and digestive organs and also for accidents and suicides. CONCLUSION: The risk of premature death seems to be higher in women who smoke during pregnancy than in other women who smoke. This may be explained either by the low proportion of those who stop later and the high proportion of heavy smokers or by other characteristics of these subjects that increase the risk.

Cause of Death↗
PubMed1995

Juvenile offenders, with special reference to sex differences.

Social and demographic background variables relevant to male and female juvenile offenders were studied prospectively in a geographically defined population of 6,007 males and 5,757 females in Northern Finland, together with the distribution of offences by type and number between the sexes. Up to the age of 25 years, 532 males (8.9%) and 60 females (1.0%) had committed at least one crime leading to a criminal record. An intelligence quotient (IQ) of 50-84, but not below 50, was most closely associated with delinquency, as was school performance, in that not only was poor attainment associated with an increased incidence of delinquency, but above-average attainment was also predictive of a lower incidence. This is not interpreted as a causal association but rather an indication of similarity between the demands of the educational system and demands regarding socially desirable behaviour. The demographic, social, educational and health factors predictive of delinquency were very similar for males and females, and the reasons for the difference in the incidence of delinquency between the sexes must be looked for among the general differences in cultural demands and biological factors.

Adolescent↗
PubMed1995

Maternal build and pregnancy outcome.

The effect of maternal build on the outcome of pregnancy was studied in two birth cohorts in Northern Finland, for 1966 and 1985-86. Prospectively collected data were available for 10,969 women in the earlier cohort and 9128 in the later one. The women in the earlier cohort were on average 2.9 cm shorter but 0.2 kg thinner and had 0.7 kg/m2 greater BMI. 13% of the women in the earlier cohort had a BMI below 20, but 24% in the later one, while 96% in both cohorts had BMI below 30. The women with low BMI were on average taller than the others, and at all BMI levels the women of the earlier cohort were shorter and lighter than those of the later one. The outcome of pregnancy was measured by the incidence of pre-term births and perinatal plus childhood deaths up to the age of 4 years, and the association of maternal body measurements with low birth weight (< 2500 g) and small for gestational age (SGA) infants was also studied. An additive logistic regression model was fitted in each analysis, to determine the probability of the outcome separately in terms of BMI, weight and height, adjusting for maternal age, parity, smoking, marital status, father's social class and place of residence. No evidence was found that BMI values 20-25, commonly judged as optimum for the mother's own longevity, predicted a better prognosis for the child than values below 20.(ABSTRACT TRUNCATED AT 250 WORDS)

Body Mass Index↗
PubMed1995

Smoking or quitting during pregnancy: associations with background and future social factors.

Current and future social factors associated with smoking habits during pregnancy were assessed. Data on maternal smoking, social background and the family's development during the 21 years after delivery were gathered for a prospective longitudinal cohort study of 12,068 pregnant women and their children in Northern Finland in 1966 and for a second birth cohort of 9,362 mothers in 1985-86. The prevalence of smoking before pregnancy was 22% in the 1966 cohort (29% in 1985-86). 12% (18%) of the women continued smoking throughout their pregnancy. The following background factors were mainly associated with the mother's smoking and/or continuing during pregnancy in both cohorts when mother's age, parity, place of residence and social class were standardized: mother's age under 23, parity two or more, low social class, urban dwelling, unmarried, gainful employment and heavy smoking. The follow-up responses after 14 and 21 years, respectively, were mostly more favourable among the non-smoking mothers and those who quit smoking during pregnancy-e.g. stable family structure, child's smoking and drinking habits and application for intermediate education. Smoking throughout pregnancy or quitting of smoking late in pregnancy were associated with undesirable future development of the child and family in most of these aspects.

Female↗