Smoking During Pregnancy Associated with Increased Risk of Schizophrenia

Summary: A new study reports on an increased risk of schizophrenia in the children of mothers who smoked during pregnancy.

Source: Columbia University.

A study by researchers at Columbia University’s Mailman School of Public Health, Columbia University Medical Center (CUMC), New York State Psychiatric Institute and colleagues in Finland reports an association between smoking during pregnancy and increased risk for schizophrenia in children. Results show that a higher maternal nicotine level in the mother’s blood was associated with an increased risk of schizophrenia among their offspring. Findings are published online in the American Journal of Psychiatry.

The paper evaluated nearly 1,000 cases of schizophrenia and matched controls among offspring born in Finland from 1983-1998 who were ascertained from the country’s national registry. Heavy maternal nicotine exposure was associated with a 38-percent increased odds of schizophrenia. The findings persisted after adjusting for factors, including maternal and parental psychiatric history, socioeconomic status, and maternal age.

“To our knowledge, this is the first biomarker-based study to show a relationship between fetal nicotine exposure and schizophrenia,” said Alan Brown, MD, MPH, senior author and Mailman School professor of Epidemiology and professor of Psychiatry at CUMC. “We employed a nationwide sample with the highest number of schizophrenia cases to date in a study of this type.”

Researchers analyzed data from a large national birth cohort of pregnant women who participated in the Finnish Prenatal Study of Schizophrenia and their offspring from the Finnish Maternity Cohort, which archived over 1 million prenatal serum specimens since 1983. Blood was collected during the first and early second trimesters. The Finnish Hospital and Outpatient Discharge Registry was used to identify all recorded diagnoses for psychiatric hospital admissions and outpatient treatment visits.

Heavy smoking based on cotinine, a reliable marker of nicotine in maternal blood sera, was reported by 20 percent of the mothers of cases, but only 15 percent of the mothers of controls.

Smoking during pregnancy is known to contribute to significant problems in utero and following birth, including low birth weight and childhood attention deficits. Nicotine readily crosses the placenta into the fetal bloodstream, specifically targets fetal brain development, causing short- and long-term changes in cognition, and potentially contributes to other neurodevelopmental abnormalities.

Photo of a pregnant woman with a cigarette.
The study shows how the protein beta-amyloid sticks to the surface of blood platelets, also known as thrombocytes, initiating a rapid chain reaction. The result is an incredibly fast-paced build-up of plaque. NeuroscienceNews.com image is adapted from the Columbia University press release.

“These findings underscore the value of ongoing public health education on the potentially debilitating, and largely preventable, consequences that smoking may have on children over time,” said Brown.

In a previous study from a different birth cohort, also reported in the American Journal of Psychiatry, Brown and colleagues found that offspring of mothers who reported smoking during pregnancy have an increased risk of bipolar disorder.

About this psychology disease research article

Co-authors: Solja Niemelä, MD, PhD, University of Oulu, Finland; Andre Sourander, MD, PhD, and Susanna Hinkka-Yli-Salomäki, PhLic., University of Turku, Finland; Heljä-Marja Surcel, PhD, National Institute of Health and Welfare, Finland; and Ian W. McKeague, PhD, and Keely Cheslack-Postava, PhD, of Columbia. Within the past 36 months, Niemelä has received honoraria from Janssen, Lilly, and Lundbeck. The other authors report no financial relationships with commercial interests.

Funding: Funding for the study was provided by the National Institute of Mental Health, grants R01 MH082052, K02 MH065422, and grant 2R01 GM095722-05 from the National Institute of General Medical Sciences.

NeuroscienceNews would like to thank Stephanie Berger for submitting this psychology research article to us for inclusion.

Source: Stephanie Berger – Columbia University
Image Source: This NeuroscienceNews.com image is adapted from the Columbia University press release.
Original Research: Abstract for “Prenatal Nicotine Exposure and Risk of Schizophrenia Among Offspring in a National Birth Cohort” by Solja Niemelä, M.D., Ph.D., Andre Sourander, M.D., Ph.D., Heljä-Marja Surcel, Ph.D., Susanna Hinkka-Yli-Salomäki, Ph.Lic., Ian W. McKeague, Ph.D., Keely Cheslack-Postava, Ph.D., and Alan S. Brown, M.D., M.P.H. in American Journal of Psychiatry. Published online May 24 2016 doi:10.1176/appi.ajp.2016.15060800

Cite This NeuroscienceNews.com Article

[cbtabs][cbtab title=”MLA”]Columbia University. “Smoking During Pregnancy Associated with Increased Risk of Schizophrenia.” NeuroscienceNews. NeuroscienceNews, 25 May 2016.
<https://neurosciencenews.com/pregnancy-smoking-schizophrenia-4308/>.[/cbtab][cbtab title=”APA”]Columbia University. (2016, May 25). Smoking During Pregnancy Associated with Increased Risk of Schizophrenia. NeuroscienceNews. Retrieved May 25, 2016 from https://neurosciencenews.com/pregnancy-smoking-schizophrenia-4308/[/cbtab][cbtab title=”Chicago”]Columbia University. “Smoking During Pregnancy Associated with Increased Risk of Schizophrenia.” https://neurosciencenews.com/pregnancy-smoking-schizophrenia-4308/ (accessed May 25, 2016).[/cbtab][/cbtabs]


Abstract

Prenatal Nicotine Exposure and Risk of Schizophrenia Among Offspring in a National Birth Cohort

Objective:
Cigarette smoking during pregnancy is a major public health problem leading to adverse health outcomes and neurodevelopmental abnormalities among offspring. Its prevalence in the United States and Europe is 12%–25%. This study examined the relationship between prenatal nicotine exposure (cotinine level) in archived maternal sera and schizophrenia in offspring from a national birth cohort.

Method:
The authors conducted a population-based nested case-control study of all live births in Finland from 1983 to 1998. Cases of schizophrenia in offspring (N=977) were identified from a national registry and matched 1:1 to controls on date of birth, sex, and residence. Maternal serum cotinine levels were prospectively measured, using quantitative immunoassay, from early- to mid-gestation serum specimens archived in a national biobank.

Results:
A higher maternal cotinine level, measured as a continuous variable, was associated with an increased odds of schizophrenia (odds ratio=3.41, 95% confidence interval, 1.86–6.24). Categorically defined heavy maternal nicotine exposure was related to a 38% increased odds of schizophrenia. These findings were not accounted for by maternal age, maternal or parental psychiatric disorders, socioeconomic status, and other covariates. There was no clear evidence that weight for gestational age mediated the associations.

Conclusions:
To the authors’ knowledge, this is the first study of the relationship between a maternal smoking biomarker and schizophrenia. It provides the most definitive evidence to date that smoking during pregnancy is associated with schizophrenia. If replicated, these findings suggest that preventing smoking during pregnancy may decrease the incidence of schizophrenia.

“Prenatal Nicotine Exposure and Risk of Schizophrenia Among Offspring in a National Birth Cohort” by Solja Niemelä, M.D., Ph.D., Andre Sourander, M.D., Ph.D., Heljä-Marja Surcel, Ph.D., Susanna Hinkka-Yli-Salomäki, Ph.Lic., Ian W. McKeague, Ph.D., Keely Cheslack-Postava, Ph.D., and Alan S. Brown, M.D., M.P.H. in American Journal of Psychiatry. Published online May 24 2016 doi:10.1176/appi.ajp.2016.15060800

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