Maternal Infection in Gestation and Risk of Mental Disorders in Offspring During Adulthood

Pavankumar Kamat

Disclosures

June 18, 2021

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.
     

 

Saatci D, van Nieuwenhuizen A, Handunnetthi L. Maternal infection in gestation increases the risk of non-affective psychosis in offspring: a meta-analysis. J Psychiatr Res. 2021;139:125-131. doi: 10.1016/j.jpsychires.2021.05.039. PMID: 34058651.  View abstract 

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.

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