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Maternal infection a risk factor for some psychiatric disorders in offspring

By Nicole MacKee
Maternal infection during pregnancy may put children at an increased risk of developing autism and depression, according to research published in JAMA Psychiatry.

After analysing registry data of almost 1.8 million Swedish children born between 1973 and 2014, researchers found that fetal exposure to any infection for which the mother was hospitalised increased a child’s risk of an inpatient diagnosis of autism spectrum disorder (hazard ratio [HR], 1.79) or depression (HR, 1.24). The researchers followed the cohort for up to 41 years, with infection and psychiatric diagnoses derived from codes during hospitalisations.

No evidence for increased risk for bipolar disorder or psychosis (including schizo­phrenia) among the offspring was found.

Professor Michael Berk, Chair of Psychiatry at Deakin University and Barwon Health, said the study confirmed maternal infection as a risk factor for some, but not all, psychiatric disorders.

‘The study had a couple of really interesting signals, both positive and negative. Broadly speaking it confirms maternal infection as a risk factor, but not a universal one for psychiatric disorders.’

He said it was surprising not to see any effect on schizophrenia risk. ‘Most of the research has been on schizophrenia, with maternal influenza and specific infections, particularly toxoplasmosis, being associated with a risk for schizophrenia,’ he said.

Professor Berk said these latest findings fed into evidence supporting the role of inflam­matory signalling in adverse neurodevelopment outcomes.

‘Maternal infection together with other early life stressors or trauma might share a propen­sity to prime the immune system,’ he said. ‘Adverse environmental factors like poor diet, inadequate physical activity and sleep disturbance also can prime the immune system, and, in theory, even [factors] like vitamin D deficiency may play a role.’

Professor Berk said there was a research focus on the role of anti-inflammatory strategies in treating depression and autism.

‘There are some studies of drugs like celecoxib [as an adjunctive treatment] in autism, with interesting preliminary signals.’

Professor Berk said these latest findings also underlined the importance of high-quality perinatal and maternal care in the prevention of neuropsychiatric disease.
JAMA Psych; doi: 10.1001/jamapsychiatry.2019.0029.