Takeaway
- Maternal infection during gestation is a risk factor for non-affective psychosis and schizophrenia in the offspring in later life.
Why this matters
- The precise underlying mechanism through which maternal infection contributes to the aetiology of non-affective psychosis is not known; however, maternal immune activation during gestation may disrupt neurodevelopmental processes.
Study design
- Researchers at the University of Oxford and the University of California performed a meta-analysis of 16 observational studies identified through a literature search across Medline and EMBASE databases.
- Main outcome: non-affective psychotic disorders including schizophrenia during adulthood after exposure to any maternal infection.
- Funding: National Institute for Health Research UK and others.
Key results
- Maternal infection in gestation was associated with an increased risk of non-affective psychosis (relative risk [RR], 1.28; 95% CI, 1.05-1.57; P=.02).
- In the subgroup analysis, maternal infection in gestation was linked to a greater risk of schizophrenia alone (RR, 1.65; 95% CI, 1.23-2.22; P=.0008).
- Maternal infection in the second trimester was associated with an increased risk of non-affective psychosis (RR, 1.63; 95% CI, 1.07-2.48; P=.02).
- The risk of non-affective psychosis from the first (RR, 1.68; 95% CI, 0.97-2.90; P=.06) and third trimesters (RR, 1.14; 95% CI, 0.76-1.71; P=.50) did not meet statistical significance.
- Serologically detected maternal exposure to lifelong infections was linked to an increased risk of non-affective psychosis (OR, 1.22; 95% CI, 1.05-1.43; P=.01).
Limitations
- Risk of confounding.
This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.
