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Published on: March 25, 2016
In utero infection and adult schizophrenia
1Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York State Psychiatric Institute, New York, New York 10032, USA. asb11@columbia.edu
Insights
Prenatal infections, such as rubella and respiratory infections, are emerging risk factors for schizophrenia. These in utero exposures may impact brain development, increasing adult schizophrenia liability.
Area of Science:
- Neuroscience
- Psychiatry
- Epidemiology
Background:
- Emerging evidence suggests prenatal infection is a risk factor for schizophrenia.
- In utero infections may disrupt critical brain development, contributing to schizophrenia pathogenesis.
- Previous studies linking schizophrenia to birth season or epidemics have yielded equivocal results.
Purpose of the Study:
- To review evidence for in utero infection as a risk factor for schizophrenia.
- To examine the impact of prenatal infections on brain maturation and schizophrenia liability.
- To present findings from sophisticated research designs and ongoing birth cohort investigations.
Main Methods:
- Review of emerging evidence on prenatal infection and schizophrenia risk.
- Analysis of sophisticated research designs with refined exposure and outcome measures.
- Ongoing birth cohort investigations, including analysis of maternal serum samples.
Main Results:
- Associations found between schizophrenia and in utero rubella infection.
- Associations identified between schizophrenia and prenatal respiratory infections.
- Ongoing studies are expected to further elucidate these relationships.
Conclusions:
- In utero infections, including rubella and respiratory infections, are potential risk factors for schizophrenia.
- Prenatal infection's adverse effects on brain development may increase adult schizophrenia risk.
- Continued research, particularly birth cohort studies, is crucial for understanding this link.
Abstract:
We review emerging evidence indicating that in utero exposure to infection is a risk factor for schizophrenia. It is hypothesized that a prenatal infection increases the liability to schizophrenia in adulthood by adversely affecting the maturation of critical brain structural and functional components implicated in the pathogenesis and pathophysiology of the disorder. Early evidence for a role of in utero infection includes investigations linking schizophrenia with birth during the winter and in urban regions, and ecologic studies demonstrating associations between influenza epidemics and births of pre-schizophrenic patients. The findings of the latter studies are, however, equivocal. To more rigorously address this question, our group has used increasingly sophisticated research designs that incorporate more refined measures of exposure and outcome, and continuous follow-up of treated cases. This work has already yielded several intriguing findings, including associations between schizophrenia and two in utero infections--rubella and respiratory infection. We also describe our ongoing birth cohort investigations that are expected to advance this work further, including studies that utilize maternal serum samples drawn during pregnancy of offspring who were later diagnosed with schizophrenia.
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