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Open Access Highly Accessed Research article

Acute maternal stress in pregnancy and schizophrenia in offspring: A cohort prospective study

D Malaspina1, C Corcoran23, KR Kleinhaus2, MC Perrin1, S Fennig45, D Nahon6, Y Friedlander7 and S Harlap18*

Author Affiliations

1 Department of Psychiatry, New York University School of Medicine, New York, NY, USA

2 Department of Psychiatry, Columbia University, New York, NY, USA

3 New York State Psychiatric Institute, New York, NY, USA

4 Shalvata Mental Health Center, Ramat Gan, Israel

5 Sackler School of Medicine, Tel Aviv University, Israel

6 Department of Information and Evaluation, Ministry of Health, Jerusalem, Israel

7 Braun School of Public Health, Hebrew University of Jerusalem, Israel

8 Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA

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BMC Psychiatry 2008, 8:71  doi:10.1186/1471-244X-8-71

Published: 21 August 2008

Abstract

Schizophrenia has been linked with intrauterine exposure to maternal stress due to bereavement, famine and major disasters. Recent evidence suggests that human vulnerability may be greatest in the first trimester of gestation and rodent experiments suggest sex specificity. We aimed to describe the consequence of an acute maternal stress, through a follow-up of offspring whose mothers were pregnant during the Arab-Israeli war of 1967. A priori, we focused on gestational month and offspring's sex.

Method

In a pilot study linking birth records to Israel's Psychiatric Registry, we analyzed data from a cohort of 88,829 born in Jerusalem in 1964–76. Proportional hazards models were used to estimate the relative risk (RR) of schizophrenia, according to month of birth, gender and other variables, while controlling for father's age and other potential confounders. Other causes of hospitalized psychiatric morbidity (grouped together) were analyzed for comparison.

Results

There was a raised incidence of schizophrenia for those who were in the second month of fetal life in June 1967 (RR = 2.3, 1.1–4.7), seen more in females (4.3, 1.7–10.7) than in males (1.2, 0.4–3.8). Results were not explained by secular or seasonal variations, altered birth weight or gestational age. For other conditions, RRs were increased in offspring who had been in the third month of fetal life in June 1967 (2.5, 1.2–5.2), also seen more in females (3.6, 1.3–9.7) than males (1.8, 0.6–5.2).

Conclusion

These findings add to a growing literature, in experimental animals and humans, attributing long term consequences for offspring of maternal gestational stress. They suggest both a sex-specificity and a relatively short gestational time-window for gestational effects on vulnerability to schizophrenia.