title: Maternal exposure to sexually transmitted infections and schizophrenia among offspring.
abstract: Animal models and epidemiologic studies suggest that prenatal maternal infection, and sexually transmitted infection (STI) in particular, is associated with an increased risk of schizophrenia in the offspring. However, findings from prior research studies on common infections, including herpes simplex virus type 2 (HSV-2) and Chlamydia trachomatis (C. trachomatis) have been inconsistent. To investigate these associations, we conducted a case-control study nested in the population-based Finnish Prenatal Study of Schizophrenia. Using linked national registries, 963 cases with schizophrenia (ICD-10 F20) or schizoaffective disorder (ICD-10 F25), and 963 matched controls were identified from among all persons born between 1983 and 1998 in Finland. HSV-2 IgG antibody levels were quantified in archived maternal serum samples drawn during pregnancy. Mothers of 16.4% of cases versus 12.6% of controls were HSV-2 seropositive. Mean levels of maternal HSV-2 IgG were marginally higher among cases than controls (index values of 0.98 versus 0.86; p=0.06). The unadjusted odds ratio (OR) of maternal HSV-2 IgG seropositivity was 1.33 (95% confidence interval (CI)=1.03-1.72, p=0.03). Following adjustment for covariates, the relationship was attenuated (OR=1.22, CI=0.93-1.60; p=0.14). In an exploratory analysis of another STI, C. trachomatis antibodies were measured in a subsample of 207 case-control pairs drawn from the cohort. The proportions of subjects that were seropositive and the mean levels of C. trachomatis antibodies were similar for cases and controls. This study does not support a strong association of HSV-2 or C. trachomatis IgG antibodies in maternal serum during early to mid-gestation with the development of schizophrenia in the offspring.
authors.affiliation: Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, United States.
authors.forename: Keely
authors.initials: K
authors.lastname: Cheslack-Postava
authors.affiliation: Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, United States; Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, New York, NY 10032, United States. Electronic address: asb11@columbia.edu.
authors.forename: Alan S
authors.initials: AS
authors.lastname: Brown
authors.affiliation: Department of Child Psychiatry, Faculty of Medicine, University of Turku, Turku, Finland.
authors.forename: Roshan
authors.initials: R
authors.lastname: Chudal
authors.affiliation: Department of Child Psychiatry, Faculty of Medicine, University of Turku, Turku, Finland.
authors.forename: Auli
authors.initials: A
authors.lastname: Suominen
authors.affiliation: Department of Child Psychiatry, Faculty of Medicine, University of Turku, Turku, Finland.
authors.forename: Jukka
authors.initials: J
authors.lastname: Huttunen
authors.affiliation: National Institute for Health and Welfare, Oulu, Finland.
authors.forename: Helja-Marja
authors.initials: HM
authors.lastname: Surcel
authors.affiliation: Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, United States; Department of Child Psychiatry, Faculty of Medicine, University of Turku, Turku, Finland; Department of Child Psychiatry, Turku University Hospital, Turku, Finland.
authors.forename: Andre
authors.initials: A
authors.lastname: Sourander
mesh_terms: D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood; D000914:Antibodies, Viral / Q000097:blood; D016022:Case-Control Studies; D002690:Chlamydia Infections / Q000453:epidemiology; D002692:Chlamydia trachomatis / Q000276:immunology; D005260:Female; D005387:Finland / Q000453:epidemiology; D006558:Herpes Genitalis / Q000453:epidemiology; D018258:Herpesvirus 2, Human / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D018811:Maternal Exposure; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D011297:Prenatal Exposure Delayed Effects; D011618:Psychotic Disorders / Q000453:epidemiology*; D012042:Registries; D012559:Schizophrenia / Q000453:epidemiology*; D012749:Sexually Transmitted Diseases / Q000453:epidemiology*
chemical_list: D000907:Antibodies, Bacterial; D000914:Antibodies, Viral; D007074:Immunoglobulin G
keywords: Chlamydia; Epidemiology; HSV-2; Prenatal infection; Schizophrenia