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Bacterial infection during pregnancy associated with psychosis in offspring

Maternal bacterial infection during pregnancy is associated with a significantly higher risk for psychotic disorders in offspring depending on severity of the infection and offspring sex, according to a study published in The American Journal of Psychiatry.

The study included data from 15,421 participants of live births between 1959 and 1966 at the Boston and Providence sites of the Collaborative Perinatal Project. Researchers identified those with psychotic disorders among the original parents and among the adult offspring. Trained nonphysician interviewers and physicians collected exposure data from participants at the time of registration for prenatal care, at intervals of 4 weeks during the first 8 months and every week following.

“Localized bacterial infection predicted a 1.6-fold increase in the odds of developing a psychotic disorder in adulthood, and multisystemic bacterial infection predicted a nearly threefold increase in the odds,” Younga H. Lee, PhD, lead author and researcher at Brown University and colleagues wrote.

Overall, 23% of the total cohort had a bacterial infection; of these, 21% had localized infections, 3% had multisystemic infections and less than 1% had both.

The data showed that multisystemic bacterial infection was more strongly associated with offspring development of psychosis than localized bacterial infection.

The association between prenatal exposure to any bacterial infection and subsequent psychosis was affected by offspring sex. Male offspring were three times more likely to develop a psychotic disorder after exposure to bacterial infection during pregnancy, more than two times likely to develop a psychotic disorder from localized bacterial infection during pregnancy than girls and five times more likely to develop a psychotic disorder after exposure to multisystemic infection.

Results showed significant evidence that bacterial infections during pregnancy have adverse consequences in offspring causing higher risk for psychosis depending on the offspring’s sex. Maternal bacterial infection during pregnancy increased the risk for offspring development of schizophrenia and related psychoses.

“These findings could be an important first step to motivating large-scale national register-based investigation of this type of research question,” the investigators wrote. “If replicated, our findings would also call for public health and clinical efforts that focus on preventing and managing bacterial infection in pregnant women.” – by Erin T. Welsh

Disclosure: Lee reports no relevant financial disclosures. Please see the full study for all other authors’ relevant financial disclosures.