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Elevated Maternal CRP and Schizophrenia in Children

Elevated Maternal CRP and Schizophrenia in ChildrenPregnancy is an exciting yet nervous time for most expectant mothers, however new research published in September’s issue of the American Journal of Psychiatry (1) has added to the concerns that elevated CRP levels (a common marker of inflammation) is strongly linked to an increased risk of schizophrenia in their offspring.

A nested case-control study sought to investigate whether increasing levels of CRP had a positive correlation with increased likelihood of children developing schizophrenia. A total of 777 schizophrenia cases (schizophrenia, N=630; schizoaffective disorder, N=147) with maternal sera available for CRP testing were identified and matched to 777 control subjects in the analysis. Maternal CRP levels were then assessed from maternal serum specimens.

It was found that increasing CRP levels, classified as 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.

Overall, the median maternal C-reactive protein level for case patients was 2.47 mg/L. The median level for control individuals was 2.17 mg/L. The investigators also noted that for every 1 mg/L increase in maternal CRP, the risk for schizophrenia was increased by 28%.

Although researchers are not entirely sure of the precise mechanism, the investigators hypothesise that “maternal inflammation during pregnancy may ‘prime’ the brain to broadly increase the risk for the later development of different types of psychiatric syndromes.”

Mary Cannon, MD, PhD, and colleagues from the Departments of Psychiatry and Psychology, Royal College of Surgeons in Dublin, Ireland, spoke out about the research in an accompanying editorial (2) where she stated the clinical importance of the findings and that: “Indeed, infection during pregnancy is an increasing concern of obstetricians, since recent evidence indicates that pregnant women are particularly vulnerable to certain infections … stress management, and treatment of depression and anxiety, does encompass the responsibilities of psychiatrists who work with pregnant women. Comprehensive psychiatric and psychological treatment for expectant mothers, as well as physical monitoring, would now seem indicated not only for the health of the mother but also to thereby decrease the longer-term risk for mental illness in her child.”

References

1. The American Journal of Psychiatry
2. Priming the Brain for Psychosis: Maternal Inflammation During Fetal Development and the Risk of Later Psychiatric Disorder

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