Elevated Maternal C-Reactive Protein and Increased Risk of Schizophrenia in a National Birth Cohort

• Published in: The American journal of psychiatry Vol. 171; no. 9; pp. 960 - 968
• Main Authors: Canetta, Sarah, Sourander, Andre, Surcel, Heljä-Marja, Hinkka-Yli-Salomäki, Susanna, Leiviskä, Jaana, Kellendonk, Christoph, McKeague, Ian W., Brown, Alan S.
• Format: Journal Article
• Language: English
• Published: United States American Psychiatric Association 01.09.2014
• Subjects: Adult; Biological Specimen Banks; Biomarkers; C-Reactive Protein - analysis; Case-Control Studies; Cohort Studies; Confidence Intervals; Female; Finland - epidemiology; Humans; Immunoassay; Inflammation - blood; Inflammation - epidemiology; Male; Odds Ratio; Pregnancy; Pregnancy Proteins - blood; Prenatal Exposure Delayed Effects - blood; Prenatal Exposure Delayed Effects - epidemiology; Proteins; Psychiatry; Psychopathology; Risk Assessment; Risk Factors; Schizophrenia; Schizophrenia - epidemiology; Schizophrenia - etiology; Socioeconomic factors; Finland
• ISSN: 0002-953X; 1535-7228; 1535-7228
• DOI: 10.1176/appi.ajp.2014.13121579

Maternal inflammation level during pregnancy was related to risk of schizophrenia in offspring, adding new evidence for the association of infection and immune activation with the development of the disorder. Objective The objective of the present study was to investigate an association between early gestational C-reactive protein, an established inflammatory biomarker, prospectively assayed in maternal sera, and schizophrenia in a large, national birth cohort with an extensive serum biobank. Method A nested case-control design from the Finnish Prenatal Study of Schizophrenia cohort was utilized. A total of 777 schizophrenia cases (schizophrenia, N=630; schizoaffective disorder, N=147) with maternal sera available for C-reactive protein testing were identified and matched to 777 control subjects in the analysis. Maternal C-reactive protein levels were assessed using a latex immunoassay from archived maternal serum specimens. Results Increasing maternal C-reactive protein levels, classified as a continuous variable, were significantly associated with schizophrenia in offspring (adjusted odds ratio=1.31, 95% confidence interval=1.10–1.56). This finding remained significant after adjusting for potential confounders, including maternal and parental history of psychiatric disorders, twin/singleton birth, urbanicity, province of birth, and maternal socioeconomic status. Conclusions This finding provides the most robust evidence to date that maternal inflammation may play a significant role in schizophrenia, with possible implications for identifying preventive strategies and pathogenic mechanisms in schizophrenia and other neurodevelopmental disorders.