Maternal Infection and Schizophrenia

Implications for Prevention

Alan S. Brown; Paul H. Patterson

Disclosures

Schizophr Bull. 2011;37(2):284-290. 

In This Article

Abstract and Introduction

Abstract

Accumulating evidence suggests that maternal infection is a risk factor for schizophrenia. Prospective epidemiological studies indicate that maternal influenza, toxoplasmosis, and genital/reproductive infection are associated with this disorder in offspring. Preclinical models of maternal immune activation have supported the neurobiological plausibility of these microbes in schizophrenia. Previous studies suggest that treatment or prophylactic efforts targeting these and other infections could have significant effects on reducing the incidence of schizophrenia, given that they are common in the population and the effect sizes derived from epidemiological studies of these and other microbial pathogens and schizophrenia, to date, are not small. Fortunately, the occurrence of many of these infections can be reduced with relatively practical and inexpensive interventions that are scalable to large populations given adequate resources. Hence, in the present article, we focus on the potential for prevention of schizophrenia by control of infection, using these 3 categories of infection as examples. Lessons learned from previous successful public health efforts targeting these infections, including the relative advantages and disadvantages of these measures, are reviewed.

Introduction

Accumulating data from epidemiological studies have implicated maternal infection in the etiology of schizophrenia. Infection is an especially appropriate candidate risk factor for this theme issue of Schizophrenia Bulletin focused on prevention because it is a prototype of an exposure for which preventive interventions have been implemented on a large scale with great success in eradication and control.

Maternal infection is generally regarded as 1 of the more plausible risk factors for schizophrenia, given that microbial pathogens have been clearly documented to cause congenital brain anomalies and a variety of learning and behavioral disorders in childhood. It has been known for many years that subjects exposed to rubella, toxoplasma, herpes simplex virus type 2 (HSV-2), and other infections during pregnancy are at substantially increased risk of neurodevelopmental disorders, including mental retardation, learning disabilities, sensorineural dysfunction, and structural brain anomalies.[1]

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