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Prenatal Infection and Schizophrenia: A Review of Epidemiologic and Translational Studies
Open accessAbstract
An emerging literature from epidemiologic, clinical, and preclinical investigations has provided evidence that gestational exposure to infection contributes to the etiology of schizophrenia. In recent years, these studies have moved from ecologic designs, which ascertain infection based on epidemics in populations, to investigations that have capitalized on reliable biomarkers in individual pregnancies. These studies have documented specific candidate infections that appear to be associated with an elevated risk of schizophrenia. Animal models of maternal immune activation inspired by this work have revealed intriguing findings indicating behavioral, neurochemical, and neurophysiologic abnormalities consistent with observations in schizophrenia. In parallel studies in humans and animals, investigators are working to uncover the cellular and molecular mechanisms by which in utero exposure to infection contributes to schizophrenia risk. In this review, the authors discuss and critically evaluate the epidemiologic literature on in utero exposure to infection and schizophrenia, summarize emerging animal models of maternal immune activation, and discuss putative unique and common mechanisms by which in utero exposure to infection alters neurodevelopment, potentially increasing susceptibility to schizophrenia. The promise of this work for facilitating the identification of susceptibility loci in genetic studies of schizophrenia is illustrated by examples of interaction between in utero exposure to infection and genetic variants. The authors then elaborate on possible implications of this work, including the use of preventive measures for reducing the incidence of schizophrenia. Finally, they discuss new approaches aimed at addressing current challenges in this area of research.
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“it has been proposed that maternal inflammation may represent a pathway by which infectious and other insults may give rise to neurodevelopmental disorders8, 10.”
From Elevated maternal C-reactive protein and autism in a national birth cohort (2014) · cites this paper as [10]
In the citing paper
“Multiple animal models of prenatal infection have found evidence of diverse neurobehavioral abnormalities, whether through direct exposure of pregnant mice or rodents to influenza virus, or through non-infectious activation of the maternal immune system (e.g., using RNA poly(I:C) to stimulate an antiviral inflammatory response or lipopolysaccharide to stimulate a bacterial inflammatory response) (”
From Maternal hospitalization with infection during pregnancy and risk of autism spectrum disorders (2015) · cites this paper as Brown and Derkits, 2010
In the citing paper
“Epidemiological data showed significantly increased risk of developing schizophrenia after prenatal microbial infection [169].”
From The Role of Microbiota-Gut-Brain Axis in Neuropsychiatric and Neurological Disorders (2021) · cites this paper as [169]
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Metadata
- Authors
- Brown, A. S., & Derkits, E. J.
- Affiliations
- New York State Psychiatric Institute (US)
- ORCID
- Brown, Alan S.
- Venue
- American Journal of Psychiatry
- Published
- 2010-03-01
- Volume
- 167
- Issue
- 3
- Pages
- 261-280
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- PMC
- PMC3652286
- OpenAlex
- W2040789766
- Cited by
- 1,269
- References
- 99
- Citations by year
- 2026: 33 · 2025: 47 · 2024: 73 · 2023: 68 · 2022: 74 · 2021: 78 · 2020: 90 · 2019: 79 · 2018: 84 · 2017: 68 · 2016: 90 · 2015: 89 · 2014: 87 · 2013: 89 · 2012: 98
- FWCI
- 34.35
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (K02MH065422, R01MH082052, R01MH060249, 1R01MH-082052-01A1)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (N01-HD13334, N010HD-6-3258)
- Topics
- Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- prenatal infection, schizophrenia, maternal immune activation, intrauterine infection, brain development, animal models, genetic susceptibility loci, gene-environment interaction, infection biomarkers, schizophrenia prevention, etiology of schizophrenia
- MeSH terms
- Animals, Cross-Sectional Studies, Female, Herpes Genitalis, Humans, Infant, Newborn, Influenza, Human, Pregnancy, Pregnancy Complications, Infectious, Prenatal Exposure Delayed Effects, Pyelonephritis, Risk Factors, Schizophrenia, Social Environment, Toxoplasmosis, Congenital, Cohort Studies, Causality, Cytokines, Genetic Predisposition to Disease, Epigenesis, Genetic, Mice, Rats, Genome-Wide Association Study
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