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Epidemiological Evidence that Maternal Influenza Contributes to the Aetiology of Schizophrenia

An Analysis of Scottish, English, and Danish Data

Published online by Cambridge University Press:  02 January 2018

W. Adams
Affiliation:
Medical Statistics Unit, University of Edinburgh Medical School, Teviot Place, Edinburgh EH8 9AF
R. E. Kendell*
Affiliation:
University of Edinburgh
E. H. Hare
Affiliation:
The Bethlem Royal and Maudsley Hospitals
P. Munk-Jørgensen
Affiliation:
University of Aarhus, Denmark
*
The Scottish Office, St Andrew's House, Edinburgh EH1 3DG

Abstract

The epidemiological evidence that the offspring of women exposed to influenza in pregnancy are at increased risk of schizophrenia is conflicting. In an attempt to clarify the issue we explored the relationship between the monthly incidence of influenza (and measles) in the general population and the distribution of birth dates of three large series of schizophrenic patients - 16 960 Scottish patients born in 1932–60; 22 021 English patients born in 1921–60; and 18 723 Danish patients born in 1911–65. Exposure to the 1957 epidemic of A2 influenza in midpregnancy was associated with an increased incidence of schizophrenia, at least in females, in all three data sets. We also confirmed the previous report of a statistically significant long-term relationship between patients' birth dates and outbreaks of influenza in the English series, with time lags of - 2 and - 3 months (the sixth and seventh months of pregnancy). Despite several other negative studies by ourselves and others we conclude that these relationships are probably both genuine and causal; and that maternal influenza during the middle third of intrauterine development, or something closely associated with it, is implicated in the aetiology of some cases of schizophrenia.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1993 

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