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Several recent epidemiological studies suggest that exposure to influenza during gestation
increases the risk of later developing schizophrenia. Inconsistency exists, however,
particularly in studies that have examined the relationship between the prevalence
of influenza and the monthly number of schizophrenic births, over many years. Our
sample (N = 9462) was obtained from a Danish computerized case register, and consisted of schizophrenic
patients born between 1915 and 1970, and first admitted to Danish psychiatric hospitals
between 1971 and 1991. The study sample was chosen to represent “incidence cases”
to allow us to calculate the population attributable risk fraction (PAF). The temporal
correlation of fluctuations in the prevalence of influenza and fluctuations in the
monthly number of preschizophrenic births was examined using a Poisson regression
analysis. Exposure to influenza 4 months prior to birth (i.e., about the 6th month
of gestation) was significantly associated with an increased risk of later schizophrenia,
especially for narrowly defined schizophrenia. The number of schizophrenic births
was found to have risen by 12% (95% confidence interval: 1–24%) for every 100,000
cases of influenza in the 4th month before birth. Our model indicates the PAF to be
1.4%, that is, only 1.4% of the whole schizophrenic sample is attributed to prenatal
exposure to influenza. Although maternal exposure to influenza during midgestation
is not a major risk factor for schizophrenia, the elucidation of its causal mechanism
may open the avenue to understanding the neurodevelopmental origins of the disease.
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Article info
Publication history
Received in revised form:
September 25,
1995
Received:
August 31,
1994
Footnotes
The study was supported by the Theodore and Vada Stanley Foundation (N.T. is a Stanley Research Fellow).
Identification
Copyright
© 1996 Society of Biological Psychiatry. Published by Elsevier Inc.
